The Leawood, Kan.-based American Academy of Family Physicians (AAFP) has not hid its displeasure with the meaningful use program, most recently writing a letter to Department of Health and Human Services (HHS) Secretary Sylvia Burwell asking her to hit the pause button on the program.
On Oct. 6, the Centers for Medicare & Medicaid Services (CMS) released both the Stage 3 final rule and the Stage 2 modifications final rule together in a 752-page document. Most health IT leaders responded to the rule with cautious optimism, and many further believed that the required start date of 2018 for Stage 3 is too soon. Specifically regarding the Stage 3 final rule, CMS announced a 60-day public comment period to facilitate additional stakeholder feedback. Soon after that, AAFP launched a Speak Out tool to help family physicians demand that their representatives do just that against the MU program.
In a Dec. 2 letter to Burwell, AAFP Board Chair Robert Wergin, M.D., said the Academy shares the agency's desire to achieve practice and payment transformation and to move the healthcare system toward the lofty goals of the "Triple Aim," but he expressed great concern that the final rule fell far short of expectations and, in fact, placed "further obstacles in the path to this goal." Dr. Wergin specifically cited a 27 percent decrease in physician satisfaction with their electronic health records (EHRs) since the launch of the meaningful use program. He pointed to CMS data as evidence of declining participation in a program that experienced a serious backslide in growth (negative 11 percent) from 2013 to 2014.
Wergin even said that some of the most enthusiastic early adopters of EHR have dropped out of the program."These statistics—and the palpable frustration in the EP (eligible professional) community point to a program in crisis," said Wergin. “And unfortunately, implementation of Stage 3 will only exacerbate the program,” he added.
Wergin said that some of the problem lies with the EHR vendor community that, since 2010, has devoted most of its research and development resources toward acquiring the components necessary for meaningful use certification and leaving the EHR functionalities physicians need to achieve value-based payment "on the back burner." What’s more, “interoperability is moving at a snail's pace,” said Wergin, leaving the AAFP "deeply concerned" that family physicians will not be successful in the value-based payment environment outlined in the Medicare Access and CHIP Reauthorization Act (MACRA) and stamped with a 2018 deadline. As such, he has urged CMS to hit the pause button on meaningful use, asking the agency to "refocus and streamline" efforts related to meaningful use and to put interoperability at the top of the list.
AAFP is not alone in its feelings regarding Stage 3. About a month ago, the American Medical Association (AMA) and 110 other medical associations sent letters to members of the Senate and the House urging lawmakers to intervene with Stage 3 of the meaningful use program. Nonetheless, the 60-day comment period for stakeholders is expected to end Dec. 15. CMS has said that its Stage 3 rule is indeed final, and that any changes based on the industry’s comments will apply to future rulemaking such as MACRA.