DeSalvo: Meaningful Use Policy is Alive

Reports of the demise of the Meaningful Use program—involving Stage 3—has been highly exaggerated, in accordance to Karen DeSalvo, MD, National Coordinator for Health Information Technology, who spoke yesterday at a joint HIT Policy and Standards Committee meeting.

While the Obama administration is moving forward with its transformation to value-based payment and the Medicare Access and CHIP Reauthorization Act (MACRA) approved by Congress previous year, DeSalvo asserted that MACRA will not happen overnight; proposed regulations are hoped this spring for public comment, she stated. And physicians will sustain to be measured on their meaningful use of certified EHR technology for the intentions of determining their Medicare payments.

“We are moving to an area where we are rewarding better results and using health IT, instead of concentrating on rewarding health IT specifically,” stated DeSalvo, referring to a January 19 blog that she and CMS Acting Administrator Andy Slavitt co-authored relating to the future of the EHR Incentive Program. “We are thinking how MACRA and MIPS [the Merit-Based Incentive Payment System] vis-à-vis the Meaningful Use program will start to shift our concentration to outcomes-based rewards utilizing health IT, compared with actually incentivizing the utilization of health IT as a more near-term policy that is been victorious in the previous some years.”

Enacted in the month of April 2015, MACRA involves 2 significant programs for Medicare contributors: the Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APMs).

DeSalvo reiterated that the Department of Health and Human Services has set as an objective that 30% of Medicare payments in the year 2016 and 50% in the year 2018 would be deployed on APMs, like accountable care organizations, bundled payments and patient-centered medical homes. The ONC chief discussed that, “as we are moving into this latest chapter” of health IT, “it is actually more about knowledge that can come from that information as opposed to considering about the adoption of platforms themselves.”

Although, the transformation will not essentially mean the end of Meaningful Use—quite the opposite, in accordance to ONC officials. Among other needs, MACRA changes participation and payment for MU for Medicare-eligible professionals and needs participants to utilize certified health IT.

As Elise Sweeney Anthony, acting director of ONC’s Office of Policy, pointed out in the meeting, 25% of the composite performance score that determines a penalty or bonus payment of physician will be deployed on meaningful use of certified EHR technology. “We are working hand in hand with CMS as we consider about what that looks like and how good to move the utilization of certified health IT forward for the profit of contributors and sufferers.”

Additionally, she claimed that under MIPS the HHS secretary has discretion to lessen the percentage weight for this performance category (but not below 15%) in any year in which the secretary assumes that the proportion of EPs who are meaningful EHR users is 75% or greater, resulting in an increase in the applicable percentage weights of the other performance sections.

Sweeney Anthony also made the situation that MACRA concentrates on Medicare EPs, not eligible hospitals, critical access hospitals or Medicaid contributors. She claimed CMS and ONC are thinking how best to align MACRA with these other stakeholders. Regardless of that, the Office of Policy director proclaimed that certified health IT policy of ONC will “sustain to flourish” in the delivery network reform and MACRA atmosphere.

“’Ding, Dong, Meaningful Use is dead! Long live Meaningful Use!’ It is bit like Monty Python. ‘I am not dead yet! But, you are nearly dead. Not yet!’” John Halamka, MD, chief information officer of Boston’s Beth Israel Deaconess Medical Center and vice chair of the Health IT Standards Committee, informed the meeting.

As an objective 3^rd party, Halamka summarized that “there is a procedure for everything,” involving the transformation from the staged Meaningful Use program to MACRA. “We have heard from Andy and Karen few very interesting directions we are all headed in as we get to more outcomes-deployed activities,” he stated. “It will be very intriguing to hear more details. It is a procedure.”