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American College of Physicians: CMS should 'reconceptualize' Meaningful Use

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The Medicare Access and CHIP Reauthorization Act (MACRA), which will move many physicians out of the Meaningful Use program and into a new Merit Based Incentive Payment System (MIPS), provides the Centers for Medicare & Medicaid Services with an opportunity to "reconceptualize" Meaningful Use, according to Peter Basch, M.D. and Thomson Kuhn with the American College of Physicians (ACP).

In a recent post published in the Health Affairs Blog, Basch, the medical director for ambulatory EHR and health IT policy for MedStar Health, who also serves as ACP's chair of the medical informatics committee, and Kuhn, ACP's senior system architect, argue that the existing Meaningful Use program went "off course" by viewing the value of electronic health records the same for all physician specialties and care settings, and via CMS' application of threshold requirements to EHR functional use measures. That, they say, caused clinicians to use workarounds and "gimmicks" to satisfy them. However, they note, Meaningful Use cannot be dropped without an act of Congress, and Stage 3 shouldn't be delayed, because that would result in the existing, inadequate Stage 2 rules being "cobbled" into MIPS.

"We believe that CMS thus has a golden opportunity for an MU 'do-over,' rather than merely making incremental changes in the current program," they say.

They recommend that Meaningful Use within MACRA should, among other things:

  • Ditch "functional-use measure thresholds"
  • "Advance meaningful and practical interoperability"
  • "Develop and use flexible measures of patient engagement"

CMS acting administrator Andy Slavitt indicated last week that the Meaningful Use program would likely end in 2016. He and National Coordinator for Health IT Karen DeSalvo later clarified that the program still exists, that current law--including Stage 3--remains in effect and that Meaningful Use will "transition" over time.

To learn more:
- read the blog post

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