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The Issues of Meaningful Use Stay Alive in MACRA

The Issues of Meaningful Use Stay Alive in MACRA

The words "Meaningful Use" will no longer be applicable but that doesn't mean the remnants of the program will be gone.

In fact, "Advancing Care Information," the new term for Meaningful Use, as part of implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), has a familiar look to it. Under the Merit-Based Incentive Payment System (MIPS) track of MACRA which scores Medicare reimbursement on four categories (technology implementation and usage; quality; clinical improvement; and cost), the Advancing Care Information will essentially require physicians to attest to measures from Stage 3 of Meaningful Use to weigh their scores for the reporting period in 2017.

In other words, Meaningful Use isn't dead, it's reinvented.

For more of a breakdown on the MACRA proposed rule, click here.

Similarities and changes

It's not a complete carbon copy, as there are changes to Meaningful Use reporting.  "They've eliminated the need for [physicians] to report clinical quality measures, because that's already being done through the quality portion of MIPS," says Tom Lee, Founder and CEO of SA Ignite, a Chicago-based software firm that provides assistance to providers on reporting for federal programs.

Also gone is the "All or Nothing" approach of Meaningful Use. Providers will be given half credit for simply attesting and the performance scores will be weighted based on percentages. However, Rob Tennant, the director of health information technology policy for the Medical Group Management Association (MGMA), says upon looking deeper into the 962-page proposed rule for MACRA implementation from CMS, this might not actually be the case.

"When you read the proposed rule, page 210, it says, 'Failure to meet the submission requirements, or measure specifications for any measure in any of the objectives would result in a score of zero for the Advancing Care Information performance category base score.' I don't see that as anything other than all or nothing. Yes, they've decreased the number of requirements, but they've made it clear, at least to me, if you miss out on any [measure], you get a complete zero for this category," he says.  CMS did not comment on requests for clarification on the meaning of that line in the proposed rule.

Meanwhile, a lot isn't left up to interpretation in terms of what's carrying over from Meaningful Use to Advancing Care Information. As stated, the Stage 3 of meaningful use measures will carry over to MACRA implementation, under less demanding thresholds. This includes asking eligible professionals (EPs) to get patients to view, download, and transmit their health information; to securely message patients; to exchange health information with other providers; to send EHR data to public health registries, to secure patient data, to integrate patient-generated data, and much more. In Advancing Care Information, EPs will be able to select measures that best fit their practice. There are bonus points available in the performance aspect of Advancing Care Information, meaning if EPs do particularly well on one category, it can make up for lacking in another.

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