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

What About My Current EHR?

3. I spent a lot of money to buy the right EHR and comply with MU. Now what?

You might think that buying your EHR system and complying with MU was a bad investment, but the genie is already out of the bottle. CMS has no plans to furnish refunds. Despite all the talk of change, the government's basic commitment to EHR technology does not seem to be shaken.

The program's initial goal of incentivizing physicians and others to buy and EHR system and getting them to use it was a very positive step, says Robert M. Wachter, MD, author of The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine's Computer Age and interim chair of the department of medicine at University of California, San Francisco.

"Having everyone achieve a certain level of technology is healthy and expected," Dr Wachter says. "MU worked best when it was a program to incentivize doctors to use IT and did not micromanage how they used it." He thinks the bad part of MU came later, in the current stages of the program.

The program has certainly achieved its goal of getting most doctors to use EHRs. According to a 2014 Medscape survey,^[4] 83% of physicians said they had installed EHRs and 4% more were currently doing so. But the survey shows doctors are split on whether EHRs are actually helping them. Whereas 63% said their EHRs improved documentation and 39% said they improve collections, 38% said they worsen patient services and 35% said they worsen clinical operations.

4. Can physicians now ignore MU? Can I stop reporting?

No. Even when the new MIPS program gets under way, MU will continue rewarding and penalizing physicians. However, MU performance will be folded into MIPS, along with that of two other Medicare incentive payment programs—the Physician Quality Reporting System (PQRS) and the value-based payment modifier (VBPM)—as well as a new measurement for clinical practice improvement (CPI).

An overall penalty or payment will be assessed under MIPS. That is, physicians will receive a total yearly score based on performance in all four categories—MU, PQRS, VBPM, and CPI—and MU performance will represent 25% of the total. Depending on the total score, doctors will either receive a payment or have money removed from their Medicare reimbursements, on the basis of performance 2 years beforehand. In that performance period, doctors will be required to report all four measures.

MIPS performance reporting is expected to start in 2017, and under the 2-year payment lag, doctors will begin to see reimbursement changes in 2019. The maximum reimbursement changes will be ± 4% in 2019. Then that figure rises to 5% in 2020, 7% in 2021, and 9% in 2022, at which point it levels off.

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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.