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Federal Health IT Officials Say MU Stage 3 “Still in Effect”

January 19, 2016
by Rajiv Leventhal
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Federal health IT officials have offered some updated details on the future of the meaningful use program, predominantly noting that the existing Stage 3 regulations remain in effect and that any changes will take time to implement.  

Andy Slavitt, Centers for Medicare and Medicaid Services (CMS) Acting Administrator, and Karen DeSalvo, M.D., National Coordinator for Health IT, co-authored a column on the Office of the National Coordinator for Healthcare Information Technology’s (ONC’s) website on Jan. 19 that perhaps looked to clarify some of the confusion that resulted from last week’s surprising announcement by Slavitt that said, “The meaningful use program as it has existed will now be effectively over and replaced with something better.” 

Following the remarks made by Slavitt at the J.P. Morgan Healthcare Conference in San Francisco, the CMS director went into greater length on why the agency is looking to end the meaningful use program so soon. Specifically, on CMS’ website the next day, he said the focus will move away from rewarding providers for the use of technology and towards the outcomes they achieve with their patients. After the industry had a chance to digest those words, health IT leaders across the country cautioned folks not to overreact to what Slavitt said, noting that meaningful use will not be going away anytime soon.

Now, the Jan .19 post from DeSalvo and Slavitt has reiterated these sentiments, attesting that the feds have been working side by side with physician and consumer communities, and have listened to their needs and concerns. They said it’s time to “transition from measuring clicks to focusing on care.” DeSalvo and Slavitt wrote, “As we move forward under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), we will be sharing details and inviting comment as we roll out our proposed regulations this spring.”

They continued, “While MACRA also continues to require that physicians be measured on their meaningful use of certified electronic health record (EHR) technology for purposes of determining their Medicare payments, the law provides a significant opportunity to transition the Medicare EHR Incentive Program for physicians towards the reality of where we want to go next.” This work will be guided by several critical fundamentals, DeSalvo and Slavitt said:

  • Rewarding providers for the outcomes technology helps them achieve with their patients.
  • Allowing providers the flexibility to customize health IT to their individual practice needs. Technology must be user-centered and support physicians.
  • Leveling the technology playing field to promote innovation, including for start-ups and new entrants, by unlocking electronic health information through open application program interfaces (APIs).
  • Prioritizing interoperability by implementing federally-recognized, national interoperability standards and focusing on real-world uses of technology, like ensuring continuity of care during referrals or finding ways for patients to engage in their own care. We will not tolerate business models that prevent or inhibit the data from flowing around the needs of the patient.

What’s more, according to DeSalvo and Slavitt, as the industry works through a transition from the staged meaningful use phase to the new program as it will look under MACRA, it is important for physicians and other clinicians to keep in mind several important things, including:

  • The approach to meaningful use under MACRA won’t happen overnight. The principles were communicated now to give everyone time to plan for what’s next and to continue to give the feds input. “We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations— including meaningful use Stage 3—are still in effect.”
  • The current law requires that the meaningful use of ONC Certified Health Information Technology under the existing set of standards continues to be measured. “While MACRA provides an opportunity to adjust payment incentives associated with EHR incentives in concert with the principles we outlined here, it does not eliminate it, nor will it instantly eliminate all the tensions of the current system.”
  • It’s imperative to remember that the MACRA legislation only addresses Medicare physician and clinician payment adjustments. “The EHR incentive programs for Medicaid and Medicare hospitals have a different set of statutory requirements. We will continue to explore ways to align with principles we outlined above as much as possible for hospitals and the Medicaid program.”
  • Guidance on the new Patient Access and Medicare Protection Act, a bill designed to make it easier for healthcare providers to receive hardship exemptions from financial penalties for failing to meet MU requirements, will soon be released.

The federal officials concluded, “The challenge with any change is moving from principles to reality. The process will be ongoing, not an instant fix and we must all commit to learning and improving and collaborating on the best solutions. Ultimately, we believe this is a process that will be most successful when physicians and innovators can work together directly to create the best tools to care for patients. We look forward to working collaboratively with stakeholders on advancing this change in the months ahead.”