While at the 2016 JP Morgan Health Care Investment Conference last week, Acting CMS Administrator Andy Slavitt made comments about Meaningful Use that sparked significant stakeholder debate. The Twittersphere lit up with varying interpretations and plenty of cheering. As outlined in the transcript of his remarks, Slavitt said:
“Now that we effectively have technology into virtually every place care is provided, we are now in the process of ending Meaningful Use and moving to a new regime culminating with the MACRA implementation. The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.”
Despite what the Internet would have you believe, Administrator Slavitt’s remarks were not a surprise. In various regulations released over the past year and a half, the Administration has repeatedly acknowledged that they are listening to stakeholder feedback regarding the burden of the existing program on providers. CMS and ONC have taken some action to reduce that burden, offering providers flexibility in meeting programmatic requirements and new options for claiming exemptions that allow them to avoid meeting requirements.
The Administration has also been downplaying the significance of Meaningful Use in other ways. Meaningful Use does not feature prominently in the Administration’s interoperability roadmap, which outlines a complete set of milestones and calls to action for the public and private stakeholders over the next 10 years. The Federal Health IT Strategic Plan, 2015-2020, released by ONC in September 2015, does not mention “meaningful use” even once.
If existing Meaningful Use requirements will not be the measuring stick for modernization of patient records and information sharing in Medicare going forward, what will be?
The answer appears to be another version of Meaningful Use, at least for some providers, according to a HHS blog post that further clarifies and expands upon Administrator Slavitt’s previous remarks. In their post, Acting Administrator Slavitt and National Coordinator Karen DeSalvo indicate that the program will transition over time from one that “measures clicks” to one that focuses on care. Critical principles that will guide the program’s evolution include:
- Rewarding providers for the outcomes technology helps them achieve with their patients.
- Allowing providers the flexibility to customize health IT to their individual practice needs.
- Leveling the technology playing field to promote innovation by unlocking electronic health information through open APIs.
- Prioritizing interoperability by implementing federally recognized, national interoperability standards and focusing on real-world uses of technology.
The Administration will be releasing additional guidance outlining a framework for the program’s transition over the next couple of months. Existing Meaningful Use program requirements, including the mandatory transition to Stage 3 in 2018, are currently still in place. However, if there will be a dramatic shift away from the current framework, it is hard to imagine that the government will continue to require providers to go to the expense and trouble of upgrading their technology for just one year.
Although much remains uncertain, one thing is sure: stakeholders should begin advocating for their preferred approach by building a case using data and evidence that highlights how health IT will be used to help enable the shift to value-based care. Although 2019 may seem far away, agency officials will start now to effectuate an orderly transition. Act now before the opportunity to shape forthcoming regulations and guidance is gone.