Meaningful Use isn't dead yet

Even though passage of the Medicare Access and CHIP Reauthorization Act of 2015 will end Meaningful Use (MU) as a standalone program in a few years, physicians still should try to meet the program’s requirements, both for financial reasons and to prepare for the future.

That was the message from two panelists at the session, “Meaningful Use: Are we there yet?” at this year’s American College of Physicians (ACP) Internal Medicine Meeting in Washington, D.C. “You’re better off at least attempting to do Meaningful Use this year because it will better prepare you for what lies ahead,” said Thomson Kuhn, MA, the ACP’s director of health information technology policy, who moderated the panel.

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Doctors who begin attesting to MU this year, and who don’t serve a substantial Medicaid population, no longer are eligible for the financial incentives available under the program, explained panelist Michael Zaroukian, MD, PhD, FACP, chair-elect of the Health Information Management Systems Society. “At this point you’re basically repairing the financial penalties you’re getting as a result of not being a meaningful user,” he said.

Peter Basch, MD, chair of the ACP’s medical informatics committee and a practicing internist, noted that the financial penalties for not successfully attesting to Meaningful Use apply to all Medicare Part B payments, not just office visits. “That can add up to significant negative payment adjustments,” he said.

Basch outlined MU’s role under the Merit-based Incentive Payment System (MIPS) included in the MACRA legislation. Under MIPS, physicians will receive a composite score reflecting their performance in four categories, one of which is meaningful use of electronic health records (EHRs) and will be called advancing care information. The others are quality, resource use, and clinical practice improvement.

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“If you thought Meaningful Use was complex and hard to figure out, this is way more complicated,” he said.

Zaroukian and Basch also reviewed the modified rule for Stage 2 of the Meaningful Use program, which was finalized late in 2015, highlighting some of its most important aspects. Zaroukian noted that protecting patient health information is a higher priority than it was under earlier versions of the rule.

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“The whole issue of data security assessment and documentation of your plans to protect data is now considered job one,” he said. That includes protecting data stored on servers (“at rest”), not just when it’s being shared with other providers.

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Other steps doctors should take to comply with the rule, they said, include:

·      Ensuring that your EHR is certified according to 2014 or 2015 standards;

·      Having a patient portal and encouraging patients to use it;

·      Having and knowing how to use a method for exchanging patient information electronically with other providers; and

·      Verifying preferred pharmacies to use when e-prescribing.

These and other actions, they said, will also help physicians improve their scores when MIPS goes into effect in 2019, since those scores will be based on reporting for 2017.

Basch said that despite the frustration many physicians experience with EHRs and other forms of technology, “we’ve come a long way from where we were just five or six years ago on the road to a health system that provides better care, where we can measure what we do, and where we can be accountable for quality and cost.”