AMA: Meaningful Use requirements and penalties discourage physician participation

The American Medical Association (AMA) is calling for major reforms to the Centers for Medicare and Medicaid Services’ (CMS) Meaningful Use incentive program for electronic health records.

In a letter to CMS Administrator Marilyn Tavenner and National Coordinator for Health Information Technology Karen DeSalvo, MD, MPH, the AMA argued that without significant changes, more providers will drop out of the program.

“The AMA is concerned that the rigid program requirements and financial penalties will discourage physicians who are making good faith efforts to incorporate health IT into their practices,” the letter states. The AMA also warned that imposing stiff penalties would prevent thousands of physicians from investing in other technological resources to advance care. 

Although the reporting year began on Jan. 1, 2014, few providers have attested to Meaningful Use Stage 2 (MU2). CMS released data that shows only 50 eligible professionals and four facilities have attested to MU2 so far this year.

Among its recommendations, the AMA suggests eliminating any requirement that is outside the physician’s control. This would include the MU2 measure that requires more than 5% of a practice’s patients to access the patient portal. “Many physicians continue to report to us challenges in convincing patients to use these tools because of the patient’s own preference to speak directly with the physician,” the letter states. “It should be sufficient for physicians to exchange information they deem important and to encourage their patients to participate in their own care through innovative technologies without requiring an individual to view, download, or transmit information.”

The AMA recommends the following changes to the MU incentive program:

Stages 1 and 2

• Removing the existing program’s all-or-nothing approach and replace it with a 75% pass rate.

• Allowing physicians who meet at least 50% of the MU requirements to avoid a financial penalty.

Stage 3

• Removing the all-or-nothing approach and replace it with a 75% pass rate.

• Lowering the bar for avoiding a financial penalty to 50%.

• Removing the separation between “menu” and “core” requirements.

• Streamlining and refocusing the number of requirements.

• Removing mandates that are outside the control of physicians.

• Quality reporting programs must be aligned.

• MU mandates should be evidence-based.

• Tying mandates to tested and high-performing standards as well as implementation guides (IGs).

• Considering costs of meeting MU requirements.