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The Issues of Meaningful Use Stay Alive in MACRA : Page 2 of 2

The Issues of Meaningful Use Stay Alive in MACRA : Page 2 of 2

One of the more significant holdovers from Meaningful Use that has been incorporated into Advancing Care Information is the reporting period requirements, says Tennant. "There is a one-year reporting period [under MIPS]. That's problematic," he says. "One-year reporting is overkill. Quarterly reporting is more than fair."

He notes that physicians aren't going to turn off a module of their EHR, such as ePrescribing, from one quarter to another just to satisfy reporting requirements. In the proposed rule, CMS reasons that the full-year reporting period aligns Advancing Care Information with the other MIPS categories and gets them all on a "common timeline."

Looking ahead

Seeing as it's a proposed rule, there will be plenty of time for physicians to comment before the end of the comment period (June 30). The comments could lead to significant changes. Moreover, as Tennant notes, because this is an election year, the rule could be put on hold until a new administration is in place. Lee at SA Ignite, however, sees it as "the new black" for Medicare Part B physicians. He notes, "This is bipartisan. It's not getting overturned regardless of what happens in November."

Even with the uncertainty, both Lee and Tennant say this should be taken seriously by physicians. MACRA could have significant financial impact, as the first payment year (for 2014 reporting) could include up to a 4 percent Medicare adjustment. CMS itself projects, using 2014 data, 87 percent of solo practices will face a negative adjustment in year one of MACRA, equaling $300 million. "For some specialties, like podiatry and rheumatology, which are very heavily Medicare, this could be very significant to their bottom line," says Tennant. "Smaller practices, they are running on pretty thin margins as it is. Getting a pay cut of 4 percent, it's very meaningful for these folks."

For practices, Tennant advises taking a "good, hard look at your options," including possibly bypassing MIPS and going with the Advanced Alternative Payment Model track, which would mean joining an eligible Accountable Care Organization, Patient-Centered Medical Home, or similarly devised risk-bearing program. Tennant also says EPs will "need to be actively engaged with their EHR vendors."

Lee at SA Ignite says physicians should educate themselves, use this year as a dress rehearsal by participating in Meaningful Use and other current reporting programs, and stay on top of deadlines. "Try to optimize for your point total. That's what it's all about right now," Lee says. "You have to plan out how you need to prioritize your time. It starts on January 1, so you have eight months."

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