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Physicians left in Meaningful Use limbo


The MGMA, among others representing medical practices, is asking CMS to delay the Stage 3 rules of meaningful use to benefit physicians and patients.

The Medical Group Management Association (MGMA) recently joined organizations like the American Medical Association and American Hospital Association in urging CMS to delay the finalization of Stage 3 of its EHR Incentive Program.

In a letter to CMS acting administrator Andrew Slavitt, MGMA President and CEO Halee Fischer-Wright notes the group's strong support for the adoption of health information technology, but, "in order to maximize the success of the [meaningful use] program," it feels a delay is in order.

Related:How to fix Meaningful Use to help physicians

Among the issues the MGMA notes in its letter is the conflict between the stronger requirements in the Stage 3 proposed rule and the recently proposed relaxation of similar requirements under the Stage 2 rules. The group also advises Stage 3 should be delayed until the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is fully known. In addition to repealing the Medicare Sustainable Growth Rate (SGR) formula, MACRA also streamlines existing quality reporting programs - the Physician Quality Reporting System (PQRS), the meaningful use program, and value-based payment modifiers - under a new Merit-Based Incentive Payment System (MIPS).

In this video, Anders M. Gilberg, the MGMA's senior vice president for government affairs, discusses the confusion existing in medical practices trying to meaningfully use their EHRs and the organization's thoughts on the Stage 3 rules.

The MGMA and its 50 state affiliates represent more than 33,000 administrators and executives in over 18,000 healthcare organizations, in which 385,000 physicians practice.


NEXT: Gilberg video transcript


Video Transcript:

At this point, the vast majority of [Medical Group Management Association] members have EHRs and they are looking to optimize those EHRs for patient care, not necessarily to meet government mandates.

That said, they are fully aware of the meaningful use criteria and requirements for government reporting for meaningful use. The current Stage 2 and Stage 3 requirements and the rollout of the requirements has been problematic for physician practices. What happened this year was that 2015 requirements were finalized, but the bar was set so high that there was a lot of concern expressed by MGMA and others in the physician community. In response to those concerns, CMS issued a proposed rule to roll back and to relax some of the more onerous, unrealistic requirements.

At the same time they issued the rule to roll back some of the more onerous Stage 2 requirements, they issued a proposed rule for Stage 3, which would be implemented in the future, that had significantly more onerous requirements. It really appears like, to physician practices at this point, that the right hand doesn't know what the left hand is doing over at CMS.

What we are seeking are achievable, meaningful metrics for EHR use that focus on clinical quality and patient care and not government requirements that may or may not be relevant to the practice of medicine.

Related:MU2: Mission Impossible

At this point, for example, physician practices are required to have a certain threshold for patients accessing their EHR information via the Web. We support the ability of patients to access that information, we just don't believe there should be a threshold or a requirement of a number of patients required to access that information. That's the kind of thing that's being rolled back in the proposed rule from CMS [in Stage 2] and we are looking forward to that rule being finalized.

In the meantime, it has created a lot of heartburn for practices because that rule will not be finalized until probably later this summer, yet the current law requires … a higher bar. So that uncertainty will likely be resolved later this summer.

The Stage 3 rules, MGMA will be commenting and asking for more realistic achievable Stage 3 rules. Ideally, we want to see this program move forward and succeed for the next three years before it is sunset. The [Medicare Sustainable Growth Rate (SGR)] repeal legislation [the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)] sunsets meaningful use and that's one of the real positive things - in addition to SGR repeal - the legislation does. It creates one program, which will integrate the meaningful use criteria into a quality-based reporting program so we have an opportunity over the next three years before that's implemented in 2019 to create an achievable, patient-centered, quality-focused program. And that's what we are looking forward to over the next several years, as we get through meaningful use Stage 2 and Stage 3.

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Jennifer N. Lee, MD, FAAFP
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