Last week, Andy Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services (CMS), spoke at a health care conference. The text of his speech can be found here. His remarks touched on many subjects including Meaningful Use. The MU program is controversial because many providers feel, and with good reason, that portions of MU are a waste of time, difficult to achieve and don’t improve the provision of healthcare. Twitter blew up when Administrator Slavitt made the following comment: “The Meaningful Use program as it has existed, will now be effectively over”. This is only a partial truth, and anyone who relies on Twitter for news will be seriously misinformed. Meaningful Use, and especially the concept of using EHRs in the documentation and provision of care, is NOT going away. MU was intentionally designed to have a limited life. The legislation which established MU was passed in 2009 as part of the American Recovery and Reinvestment Act – the MU program itself was implemented in 2011. For many, if not most providers, MU incentive payments have already been received. A phase out of MU has already been contemplated and its replacement is called MIPS – more on this later.
Like many issues in Washington, Meaningful Use became a political football in the past year. Many lobbying organizations put pressure on Congress to end the program. Perhaps because of this lobbying effort Administrator Slavitt issued his guidance to show that Washington was listening. However, the full text of what he said was: “The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.” Just what “something better” is has not yet been fully defined. Stay tuned.
Starting in 2017, another piece of legislation, MACRA, will take effect. Associated with MACRA is MIPS, or the Merit-Based Incentive Payment System. In CMS’s own words: The MIPS is a new program that combines parts of the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into one single program based on quality, resource Use, clinical practice improvement and the Meaningful Use of certified EHR technology. According to Jim Tate, an expert in the field of Meaningful Use: “The failure to achieve MU of CEHRT under MIPS will cost eligible providers 25 of their maximum 100 composite MIPS scores. The potential loss of revenue dwarfs the current “payment adjustment” under the CMS EHR Incentive Program.”
Will MU change going forward? Absolutely. Administrator Slavitt intends to make changes in the design of the program, and likely even change the name. Meaningful Use has become “persona non grata” to many, and perhaps rebranding is in order.
How does all of this affect HIPAA? According to an article in Healthcare Information Security, “The biggest impact of the Meaningful Use program so far has been to wake up some healthcare providers about the importance of security and privacy”. Administrator Slavitt, in addition to his comments above, signaled an increasing emphasis on interoperability – the capability for clinical systems to easily exchange data electronically. This is an area where MU fell short, but remains an area of continued focus. With increasingly greater emphasis being placed on electronic patient data and data exchange, the protection of patient data will take on an even higher priority. We can therefore expect government focus on enforcing HIPAA compliance to only continue to grow in the future.
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