Meaningful Use: Is It Really Going Away or Just Hiding?

Can You Just Forget Meaningful Use?

When a federal official stated in January 2016 that the meaningful use (MU) program was "effectively over," it set off a wave of speculation that's still rippling through the physician community.

The remarks by Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), prompted physicians to wonder what would happen to MU—the federal government's electronic health record (EHR) incentive program. Can you relax a little about EHR performance reporting? Or is that just wishful thinking?

Here's what you need to know.

1. Is meaningful use really going away?

No, but it will change significantly.

"The meaningful use program as it has existed, will now be effectively over and replaced with something better"—that was Slavitt's full quote in a speech^[1] on January 11.

The bottom line is that MU will cease to be a self-standing program next year, and it is expected to function very differently from now. The program will be folded into the new Merit-Based Incentive Payment System (MIPS), which is scheduled to start in 2017.

In a few rather broad statements since the speech, Slavitt has indicated that MU goals will be very different under MIPS from what they are now. For example, he has talked about creating outcomes-based measures to replace MU's process-based measures. In a speech^[2] to the American Medical Association (AMA) on February 23, he said that CMS should be "rewarding providers for the outcomes that technology helps them achieve, not for using technology."

If CMS shifts to outcomes-based MU measures, "I'd be excited big-time," says Marc Probst, the chief information officer at Intermountain Healthcare in Utah. He says MU has become "irrelevant," but under the changes Slavitt is talking about, "it would be a new program."

CMS is expected to detail the new MU goals in a proposed rule that will be issued around June 1, and a final rule will be out in the fourth quarter of 2016.

2. Will any changes be made this year?

CMS officials say their hands are tied until 2017. Although the MIPS program was authorized back in April 2015, under the Medicare Access and CHIP Reauthorization Act (MACRA), it won't be implemented until next year. Until then, CMS officials say, the MU program is operating under its enabling legislation—the Health Information Technology for Economic and Clinical Health (HITECH) Act—and the old law won't allow them to make significant changes.

Kate Goodrich, director of the Center for Clinical Standards and Quality at CMS, says her office is still acting under HITECH's "performance period." The MACRA performance period "could start as early as January 1, 2017, but that has not been decided yet," she says, referring to the ongoing rule-making process.

Goodrich's view echoes statements by Slavitt and Karen DeSalvo, MD, head of the Office of the National Coordinator for Health Information Technology (ONC). "The current law requires that we continue to measure the meaningful use of ONC Certified Health Information Technology under the existing set of standards," they wrote in a CMS blog^[3] on January 19. Then, under MACRA, CMS will have "an opportunity to adjust EHR payment incentives."

Many observers, however, think that CMS and the ONC could change MU whenever they wanted to. Steve Waldren, MD, director of the Alliance for eHealth Innovation at the American Academy of Family Physicians, says it was the ONC and CMS, and not HITECH, that created details of the program, such as the stages of MU. "But they don't believe they have that authority," he says, "so they're waiting for the implementation of MACRA in 2017 to make those changes."

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Leigh Page. Meaningful Use: Is It Really Going Away or Just Hiding? - Medscape - Apr 20, 2016.