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Stakeholders to Congress: Align MACRA to MU, soften requirements

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Lawmakers should use the Medicare Access and CHIP Reauthorization Act (MACRA) to improve the Meaningful Use program and ensure the programs are consistent with each other, according to the American Hospital Association (AHA) and the College of Healthcare Information Management Executives (CHIME).

In testimony at a hearing of the House Energy and Commerce Subcommittee on Health March 17, both AHA and CHIME recommended that the Meaningful Use program move from an all-or-nothing grading system to a pass/fail approach and not penalize providers if they meet most of the requirements. The AHA specifically suggested using 70 percent as the threshold passing grade; CHIME pointed out that this change would create "parity" between eligible professionals and eligible hospitals.

The organizations also requested that reporting be streamlined and less burdensome. For instance, CHIME suggested that reporting redundancies be removed and that providers should submit data only on measures that directly advance patient care. The AHA's testimony was similar, noting that MACRA should focus on measures for reporting on "national priority" areas and consider limiting the number of reporting options over time.   

AHA and CHIME were not the only entities asking that Meaningful Use be changed. For instance, the American Academy of Dermatology advocated a gradual, phased-in approach to MACRA's Merit Based Incentive Payment System (MIPS) and alternative payment models, and that CMS "pause" Stage 3 of the Meaningful Use program to give providers the chance to catch up to Stage 2. 

"Although physicians are adopting and using EHR programs, many are still not able to meet the MU attestation requirements," AADA warns. "In fact, less than 10 percent of physicians were able to meet the MU Stage 2 requirements in 2014. If the program continues to adopt more complex standards with higher thresholds, the Academy expects to see more physicians decide the effort is not worth it and drop out of the program."

MACRA  will move many physicians out of the Meaningful Use program and into the new MIPS, although Meaningful Use will not be eliminated. Others have also suggested that MACRA gives CMS an opportunity to review and revise Meaningful Use and to reconsider Stage 3 of the program.

To learn more:
- access the hearing materials
- read CHIME's statement (.pdf)
- here's the AHA's statement (.pdf)
- read the American Academy of Dermatology's statement (.pdf)

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