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    Is Meaningful Use still meaningful?

    If you have not been reading industry social media sites lately, you missed a big announcement from the Centers of Medicare and Medicaid Services (CMS) to end Meaningful Use.         

    Andy Slavitt, the acting administrator of CMS, stated on January 11, 2016, “The Meaningful Use program as it has existed, will now be effectively over and replaced with something better. Since late last year, we have been working side by side with physician organizations across many communities—including with great advocacy from the AMA—and have listened to the needs and concerns of many. We will be putting out the details on this next stage over the next few months, but I will give you a themes guiding our implementation.”1

    Although this seems extremely relieving because you do not have to attest for Meaningful Use Stage 3 in 2016, it does not mean that the protocols can be thrown out completely and to start over from scratch. To eliminate the program completely, Congress would have to make a call to action. And if that was not difficult enough, there are other programs that are tied to the protocols of Meaningful Use, such as Merit-based Incentive Payment System (MIPS), Value-Based Modifier (VBM), and the Physician Quality Reporting System (PQRS).2

    More from Dr. Rogoff: 5 financial challenges ODs will face in 2015

    What’s next?

    We need to wait to see what Slavitt and CMS decides, but in the meantime, eligible physicians, including ODs, have the flexibility to participate in two programs: MIPS and the Alternative Payment Model (APM).

    CMS is betting that these programs will deliver quality of care, better resource use, Meaningful Use of certified EHRs (meaning EHRs that have the necessary technological capability, functionality, and security to allow eligible physicians meet the Meaningful Use criteria), and clinical improvement activities.

    Once enrolled, providers are scored compositely from 0-100 based upon four performance categories (PQRS, VBM, EHR MU, and Qualified Clinical Data Registries), in which scores are compared to specific performance benchmarks for particular periods. During the transition timeline from 2015-2018, providers are not penalized, but starting 2019, reimbursements will be subject to penalties if performance measures are not met.

    MIPS and APM programs were designed to replace Sustainable Growth Rate’s (SGR) integrated current incentive programs. SGR has been used to determine Medicare reimbursements for healthcare providers, incentivized additional—and sometimes unnecessary—care, which does not lead to lowering healthcare costs. It also lacked measures to evaluate quality of care.

    What does this mean for you?

    Bryan Rogoff, OD, MBA, CPHM
    Dr. Rogoff is an independent corporate and private practice consultant specializing in best healthcare, business, and clinical ...


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