- Following up from last week’s EHR meaningful use announcement at the JP Morgan Healthcare Conference, Andy Slavitt of the Centers for Medicare & Medicaid Services (CMS) and Karen DeSalvo, the National Coordinator for Health IT, have posted an expanded explanation of their plans for the meaningful use program going forward on the CMS blog.
As announced last week, the meaningful use program focus will shift from spurring the widespread adoption of EHRs toward a patient-centered approach to health IT use. CMS will do this by focusing more on outcomes-based measures rather than the prescriptive government measures of the past.
Slavitt and DeSalvo acknowledge the benefits the earlier stages of the EHR Incentive Programs, including in encouraging widespread EHR adoption. However, the pair maintain that it is now time for a change that will better benefit the patient.
“It's taken a tremendous commitment by physicians, hospitals, technologists, patient groups and experts from all over the country to make the progress we’ve made together in a few short years,” the two said in a public statement. “The EHR Incentive Programs were designed in the initial years to encourage the adoption of new technology and measure the benefits for patients. And while it helped us make progress, it has also created real concerns about placing too much of a burden on physicians and pulling their time away from caring for patients.”
This shifting focus aligns with the entire healthcare industry’s attempts to transition to patient-centered care. As recently as 2015, the Administration has made moves to increase value-based care, such as by asserting that 30 percent of payments will be value-based in 2016 and 50 percent by 2018.
The Administration and Congress have also implemented the Medicare Access and CHIP Reauthorization Act (MACRA), which focuses physician Medicare payments on care quality, costs, and clinical practice improvement. As MACRA includes provisions regarding the EHR Incentive Programs and meaningful use, Slavitt and DeSalvo say this is an opportune moment to adjust the goals of meaningful use to better align with patient-centered outcomes.
As stated at the JP Morgan Healthcare Conference, this transition will be guided by four central themes, including outcomes-based rewards and the flexibility to customize health IT and EHRs. Additionally, the newly-envisioned meaningful use will make changes to how EHR developers work to improve their systems.
“Leveling the technology playing field to promote innovation, including for start-ups and new entrants, by unlocking electronic health information through open APIs – technology tools that underpin many consumer applications,” Slavitt and DeSalvo explain. “This way, new apps, analytic tools and plug-ins can be easily connected to so that data can be securely accessed and directed where and when it is needed in order to support patient care.”
CMS also plans on putting a significant emphasis on interoperability by implementing policies to put an end to intentional data blocking. Slavitt and DeSalvo confirm that data blocking will not be tolerated by the government, and those who partake in data blocking will see consequences.
Slavitt and DeSalvo took special care to emphasize that these adjustments do not eliminate the meaningful use program, nor do they completely get rid of some of the industry tensions surrounding the programs. However, they do state that providers and hospitals should view this news as a sign that CMS will be taking special consideration of industry needs and are working to adjust and fine-tune their programs.
Furthermore, MACRA only allows CMS to adjust Medicare physician incentives, and not Medicaid or Medicare hospital incentives. However, CMS is reportedly exploring new ways to refocus those programs as well.
Likewise, Slavitt and DeSalvo remind the healthcare industry that the changes they discuss are not going to be implementing overnight, and providers and hospitals should continue to familiarize themselves with current legislation and prepare themselves for Stage 3 meaningful use. To make that process easier, providers and hospitals should familiarize themselves with the expanded hardship exception rules.
The pair conclude by stating that this is all part of an overarching plan to focus care on the patient by putting more power back into the hands of those who know patients the best – the providers.
“The challenge with any change is moving from principles to reality. The process will be ongoing, not an instant fix and we must all commit to learning and improving and collaborating on the best solutions,” the Slavitt and DeSalvo maintain. “Ultimately, we believe this is a process that will be most successful when physicians and innovators can work together directly to create the best tools to care for patients. We look forward to working collaboratively with stakeholders on advancing this change in the months ahead.”