The U.S. government has announced significant changes to the meaningful use program for Medicare physicians, including plans to tie the initiative into the new Medicare quality-based payment system and to make it more flexible and relevant for participants.
The meaningful use program will be folded into the Merit-Based Incentive Payment System (MIPS) under a proposal by the U.S. Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC). MIPS is being implemented as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and links Medicare payments to quality.
The move is designed to make the meaningful use program more patient-centric, practice-driven, and focused on connectivity, according to an April 27 blog post by Andy Slavitt, acting CMS administrator, and Dr. Karen DeSalvo, national coordinator of ONC.
CMS and ONC said the meaningful use program, which will be renamed Advancing Care Information (ACI), would also now:
- Allow physicians and other clinicians to choose the measures that reflect how technology best suits their day-to-day practice
- Simplify the process for achievement and provide multiple paths for success
- Align with ONC's 2015 Edition Health IT Certification Criteria
- Emphasize interoperability, information exchange, and security measures and require patients to have access to their health information through application program interfaces (APIs)
- Simplify reporting by no longer requiring all-or-nothing electronic health record measurement or quality reporting
- Reduce the number of measures to an all-time low of 11 measures, down from 18 measures, and no longer require reporting on the clinical decision-support and the computerized provider order-entry measures
- Exempt certain physicians from reporting when electronic health record technology is less applicable to their practice and allow physicians to report as a group
"These improvements should increase providers' ability to use technology in ways that are more relevant to their needs and the needs of their patients," Slavitt and DeSalvo wrote.
In addition, developers that provide more than 90% of electronic health records used by U.S. hospitals have publicly committed to making it easier to for individuals to access their own data.
"CMS and ONC will continue to use our authorities to eliminate barriers to interoperability," they wrote.
Slavitt and DeSalvo noted that Advancing Care Information would only affect Medicare payments to physician offices; Medicare hospitals or programs are not included.
"We are already meeting with hospitals to discuss potential opportunities to align the programs to best serve clinicians and patients, and will be engaging with Medicaid stakeholders as well," they wrote in the blog post.
CMS and ONC will accept public comment on the proposal for the next 60 days. If finalized, the proposal would replace the current meaningful use program and reporting would begin on January 1, 2017, along with the other components of Medicare's Quality Payment Program.
