Medicare Compliance & Reimbursement

Make sure your EHR provider is keeping up with these changes.

The latest breaking news from the Centers for Medicare & Medicaid Services (CMS) could transform your work in complying with the Electronic Health Record (EHR) Incentive Program. Here’s how remarks in a recent conference presentation unveiled a new direction for Meaningful Use.

On Jan. 11, CMS Acting Administrator Andy Slavitt spoke at the J.P. Morgan Annual Health Care Conference, dropping a bombshell on the healthcare industry regarding the future of the EHR Incentive Program, also known as “Meaningful Use.” In his remarks, Slavitt talked about ending Meaningful Use:

“Now that we effectively have technology into virtually every place care is provided, we are now in the process of ending Meaningful Use and moving to a new regime culminating with the MACRA [Medicare Access and CHIP Reauthorization Act of 2015] implementation. The Meaningful Use program, as it has existed, will now be effectively over and replaced with something better.”

Slavitt didn’t elaborate much on exactly what this “something better” will be or when it will come about. But understandably, Slavitt’s speech has “set the industry abuzz,” notes Sophie Scheidlinger, Quality Programs Advisor at Practice Fusion.

Expect 4 ‘Themes’ to New Program

“Perhaps due to all the speculation this speech created,” Slavitt then released a blog post on Jan. 19 to clarify his remarks, Scheidlinger says. Slavitt and Human & Health Services (HHS) Acting Assistant Secretary for Health, Karen DeSalvo co-authored the blog post.

Although MACRA continues to require CMS to measure physicians’ meaningful use of certified EHR technology for purposes of determining their Medicare payments, the law “provides a significant opportunity to transition the Medicare EHR Incentive Program for physician towards the reality of where we want to go next,” the blog post stated.

Look ahead: And the blog post summarized where CMS wants to go next in four main “themes:”

1. Increase the focus on patient outcomes, rather than reward providers simply for the use of technology;

2. Allow providers to customize their goals so tech companies can build around the individual practice needs, instead of the government’s needs;

3. Level the playing field for start-ups and new entrants by requiring open application program interfaces in EHRs to allow apps, analytic tools, and connected technologies to get data in and out of an EHR securely; and

4. Increase the focus and emphasis on interoperability. “We are deadly serious about interoperability,” Slavitt noted in his speech. “And technology companies that look for ways to practice ‘data blocking’ in opposition to new regulations will find that it won’t be tolerated.”

In the blog post, Slavitt and DeSalvo elaborated on the interoperability priority, noting that CMS wants to implement federally recognized, national interoperability standards and focus on real-world uses of technology, such as “ensuring continuity of care during referrals or finding ways for patients to engage in their own care.”

Not So Fast: Meaningful Use Isn’t Over Yet

Still, Slavitt and DeSalvo reminded providers that MACRA “does not eliminate … all the tensions of the current system.” Also, MACRA addresses only Medicare physician and clinician payment adjustments, and the EHR incentive programs for Medicaid and Medicare hospitals have a different set of statutory requirements.

“While it may be appealing to draw the conclusion that Meaningful Use is over or Stage 3 is null and void, we cannot responsibly do so at this point,” Scheidlinger points out. “The co-authored blog post makes very clear that the changes to Meaningful Use will come about in the yet-to-be-released details of the Merit Incentive Payment System (MIPS),” created through MACRA.

Bottom line: The blog post emphasized the fact that “the approach to meaningful use under MACRA won’t happen overnight … in the meantime, our existing regulations — including Meaningful Use Stage 3 — are still in effect.”

Nevertheless, EHR providers like Practice Fusion will need to remain nimble as CMS makes these future changes to Meaningful Use, with new MACRA regulations due out this year. In the past few months, Practice Fusion has updated its Meaningful Use Dashboard to support providers after CMS released changes to the Meaningful Use program in October 2015, Scheidlinger notes. And the company promises to adapt its certified EHR “as necessary.”

“The challenge with any change is moving from principles to reality,” Slavitt and DeSalvo wrote. “The process will be ongoing, not an instant fix, and we must all commit to learning and improving and collaborating on the best solutions …. We look forward to working collaboratively with stakeholders on advancing this change in the months ahead.”

Resources: A transcription of Slavitt’s comments at the Jan. 11 conference is available at http://blog.cms.gov/2016/01/12/comments-of-cms-acting-administrator-andy-slavitt-at-the-j-p-morgan-annual-health-care-conference-jan-11-2016. To read the co-authored CMS blog posting, go to http://blog.cms.gov/2016/01/19/ehr-incentive-programs-where-we-go-next.