Whether Meaningful Use is going away or not for physicians, big changes are coming in health IT, thanks to newly proposed rules under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Department of Health and Human Services released its hefty, 962-page proposal Wednesday.
Given the size of the document, reactions are trickling rather than flooding in, but sentiments are mixed. There’s plenty of confusion, for sure, as illustrated by this tweet about alternative payment models.
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Still digesting. Am I reading right? Providers pursuing APMs will need to commit before CMS does (i.e., Final Rule)? #LevelPlayingField
— Rich Duszak, MD (@RichDuszak) April 28, 2016
Some aren’t sold on the idea that Meaningful Use is really on its way out, since those rules, by law, account for 25 percent of Merit-based Incentive Payment System (MIPS) scores. MIPS consolidates several HHS quality programs, including Meaningful Use.
And "Meaningful Use" is going "away" by changing its name to "Advancing Care Information" #MACRA #livetweeting as I read the proposed rule
— Joy Rios (@askjoyrios) April 28, 2016
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A former senior Office of the National Coordinator for Health Information Technology official said that’s not exactly the case.
More than a name change: #meaningfuluse now "Advancing care info performance" – thresholds gone; just report https://t.co/mOBSCdZl9l #MACRA
— Jodi Daniel (@JodiDaniel) April 28, 2016
Former national coordinator Dr. Farzad Mostashari retweeted Daniel, and tweeted a whole bunch of things himself, too many to list here. That drew this appeal.
I nominate @Farzad_MD to live-comment all #regs from now on
— John Barkett (@jmbarkett) April 28, 2016
Dr. Linda Girgis already shared some of her strong feelings in a MedCitizens contribution to MedCity News, but this tweet goes beyond.
Solo practitioners are expected to lose $300 million across specialties under #MACRA. The time to opt-out of #Medicare has arrived.
— Linda Girgis MD (@DrLindaMD) April 28, 2016
Mostashari did raise questions about physician payment as well.
"total potential risk must be at least 4% of expected expenditures”- which is 100% of what primary care is paid- i.e. could bankrupt a PCP
— Farzad Mostashari (@Farzad_MD) April 27, 2016
Professional organizations also had mixed reactions. Here’s this from the Medical Group Management Association:
#MACRA rule proposes to set 2017 as first measurement year. Very tight turnaround for physician practices https://t.co/WvM7kZHnMg @mgma
— Anders Gilberg (@AndersGilberg) April 27, 2016
The largest health IT organization, the Healthcare Information and Management Systems Society, is withholding its comments until a media webinar on Friday.
Representing CIOs, the College of Healthcare Information Management Executives, doesn’t have a horse in the physician race, but is awaiting HHS action on the hospital side on Meaningful Use. CHIME was mostly happy, but is pushing for some further changes. Said President and CEO Russell Branzell:
CHIME has long supported the goals of the federal Meaningful Use program to advance health IT solutions that increase efficiency and improve patient care. While the proposed regulations are largely focused on physicians, there are elements concerning data blocking that apply to hospitals and will be of significant interest to our members.
We are encouraged that CMS Acting Administrator Andy Slavitt said the agency will continue to meet with hospital officials to create alignment across health IT programs. We look forward to working with the administration to address critical issues impacting CHIME members, including adopting a 90-day reporting period and removing the pass-fail construct for attestation.
The proposed MACRA physician rule does call for ending the pass-fail nature of attestation, but still requires a full year of reporting.
Some organizations hedged, since they haven’t had time to pore over the whole thing yet. AHIMA CEO Lynne Thomas Gordon circulated this statement:
The American Health Information Management Association is encouraged to see that the proposed rule to implement provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) includes “advancing care information” as one of the components of the Merit-based Incentive Payment System (MIPS). We support its emphasis on interoperability, information exchange, and security measures, which we believe are critical to reaching the rule’s stated long-term goal of “better care, smarter spending, and healthier people.” AHIMA will continue to analyze the proposed rule and work with its members to provide comments.
Just for good measure, HHS on Wednesday released this video about MACRA that remarkably stays away from acronymys and bureaucrat-speak.
Photo: YouTube user U.S. Department of Health and Human Services
