GAO: Meaningful Use program lacks reliable CQMs

Provider participation in the Meaningful Use incentive program has increased significantly, but the clinical quality measures being collected suffer from reliability issues and the U.S. Department of Health & Human Services lacks measures to track the progress of the program's outcomes goals, according to a new report from the Government Accountability Office.

In the report, released to the public March 6, the GAO found that a substantial number of providers that participated in the Meaningful Use program 2011 did not participate in 2012, and that the Centers for Medicare & Medicaid Services is monitoring the trend. The report also noted that changes in the program--such as the move to Stage 2 and the looming payment adjustments beginning in 2015--"make future participation difficult to estimate."

The GAO recommended that HHS develop a comprehensive strategy to better ensure the reliability of clinical quality measures data being collected, as well as use outcome oriented performance measures to monitor progress toward its goals, including improved quality of care.   

"While the EHR programs are ultimately intended to improve outcomes such as healthcare quality, efficiency, and patient safety, the agencies have not established performance measures for monitoring progress toward achieving these improvements," the report's authors said. "Although HHS expects that EHRs can help achieve improved outcomes as well as support various other healthcare reform efforts that are also intended to improve care, that result is not yet assured….

GAO said that without such monitoring, agencies will struggle to understand how challenges impacting the programs--such as ensuring the reliability of CQM data or increasing provider abilities to exchange health data--might affect their ability to achieve goals.

The Meaningful Use program has come under fire from different directions, including legislators concerned about inadequate auditing of attestation and paying of incentives and the HHS Office of Inspector General regarding the integrity of EHR use. The GAO report is one of the first government reports to express concern about the measurements themselves and whether the program is meeting its goals.  

To learn more:
- read the GAO report (.pdf)

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