Acting CMS Administrator Andy Slavitt and National Coordinator for Health IT Karen DeSalvo in a blog post further explained plans for the upcoming changes to the meaningful use program, EHR Intelligence reports.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Heath, EHR Intelligence, 1/19).

Slavitt's Previous Comments

Last week, Slavitt announced that CMS plans to phase out the meaningful use program "as it has existed."

Slavitt said that the agency is "in the process of ending meaningful use and moving to a new regime culminating with the ... implementation" of the Medicare Access and Children's Health Insurance Program Reauthorization Act.

MACRA establishes the Merit-based Incentive Payment System and Alternative Payment Models, which will replace Medicare's existing fee-for-service payment model by 2017 and 2019, respectively.

He said the replacement plan will include ending several reporting programs, such as meaningful use and the Physician Quality Reporting System, and aligning them under a new initiative. Slavitt also noted that the new program will focus on rewarding providers for patient outcomes, rather than adopting technology.

In his comments, Slavitt highlighted some "themes guiding [CMS'] implementation" of MACRA, including:

• A commitment to interoperability; and
• "Leveling the technology playing field for startups and new entrants" by requiring application programming interfaces to unlock physician organizations from "early EHR decisions" (iHealthBeat, 1/14).

Clarification of Feds' Plans

According to Healthcare Informatics, DeSalvo and Slavitt in their blog post reiterated several themes included in the initial announcement and sought to clarify some confusion that followed.

For example, they noted that current law requires the agencies to continue measuring meaningful use of certified health IT under existing standards.

Meanwhile, they said that MACRA only:

• Allows the agencies to adjust payment incentives associated with EHR use rather than eliminate them altogether (Slavitt/DeSalvo, CMS blog, 1/19); and
• Addresses Medicare clinician and physician payment adjustments, not those for Medicare or Medicaid hospitals (EHR Intelligence, 1/19).

Slavitt and DeSalvo noted that the agencies "will continue to explore ways to align with principles we outlined ... as much as possible for hospitals and the Medicaid program."

Further, they said that the new "approach to meaningful use under MACRA won't happen overnight" (CMS blog, 1/19). As such, they wrote that current laws, including Stage 3 of the meaningful use program, are still in effect (Durben Hirsch, FierceHealthIT, 1/19).

They cited a recently signed law (S 2425) that expands providers' eligibility for hardship exemptions as a way to ease the transition (The CMS Blog, 1/19).

They concluded, "The challenge with any change is moving from principles to reality," adding, "The process will be ongoing, not an instant fix, and we must all commit to learning and improving and collaborating on the best solutions" (FierceHealthIT, 1/19).