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CHIME to CMS: Time to Streamline MU, Align Quality Measures

November 18, 2015
by Rajiv Leventhal
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In a letter to the Centers for Medicare & Medicaid Services (CMS), the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) has urged policymakers to streamline the meaningful use program and reduce the reporting burden on providers by better aligning quality measures.

The letter from CHIME comes during a time when CMS has asked for stakeholder comments regarding the requests for information (RFI) with a focus on the meaningful use of certified EHR technology (CEHRT) and quality performance categories. Specifically, the RFIs seek input with regards to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that requires the establishment of a Merit-based Incentive Payment System (MIPS) and consolidates certain aspects of a number of quality measurement and federal incentive programs for Medicare physicians and other providers into one framework.

CMS released the meaningful use Stage 2 modifications and Stage 3 final rules in October, opening a 60-day comment period for feedback, which will close in December. This week, the American Medical Informatics Association (AMIA) responded to the RFI with specific suggestions, but also some insightful general comments about health IT and quality measurement in service of value-based payment, as outlined by HCI Senior Contributing Editor David Raths.

In January 2015, the Department of Health and Human Services (HHS) laid out a goal of having 30 percent of traditional Medicare payments tied to an alternative payment model, such as bundled payments or accountable care organizations (ACOs) by 2016. That number would grow to 50 percent by 2018.  Regarding Medicare fee-for-service payments, 85 percent would be tied to quality and value starting in 2016, and 90 percent in 2018.

As such, CHIME “strongly supports creating a pathway for MU whereby physicians are moved to a more flexible regulatory model and away from a ‘pass/fail’ construct. The same pathway must also be created for hospitals. Additionally, the complexities associated with quality reporting should be reduced to bring the value intended under new models of care,” the organization said in its letter, penned by CHIME Board Chair Charles Christian and CHIME CEO and President Russell Branzell.

To fulfill meaningful use objectives, providers are required to meet multiple measures and objectives. With limited exception, failure to hit any of the regulatory thresholds is deemed a failure and puts the provider at risk of financial penalties, CHIME said. In its RFI, CMS indicated a willingness to move away from pass/fail and adopt a weighted approach for physicians. CHIME said it supports such a move, and believes it should apply to hospitals as well.

“We have previously advocated for the removal of the pass/fail methodology of the meaningful use program,” the letter said, noting that the pass/fail methodology often pulls resources away from other critical areas, including pursuing interoperability and adopting other solutions that can advance patient care.

In its letter, CHIME also encouraged CMS to reduce the reporting burden by eliminating redundant measures and data collection requirements.

“Many CHIME members submit more than 20 reports across federal, state and private sector program for various clinical quality measures each month. Hours of work and expertise are required to comply with these reporting demands and such burdens are exacerbated by a lack of technical harmonization,” Christian and Branzell wrote. “The goal should be to eliminate duplicative quality measures and reporting requirements.



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