Proposed SGR fix revamps Meaningful Use program

The proposed legislation to repeal the Medicare sustainable growth rate (SGR), the method currently used to compensate participating physicians, would mean significant change for the Meaningful Use incentive program.

The bipartisan bill repeals the unpopular SGR and looks to "improve the fee-for-service system by streamlining Medicare's existing web of quality programs into one value-based performance program," according to the Senate Finance Committee's announcement.

The proposed legislation establishes a streamlined incentive payment program, called the Merit-Based Incentive Payment System (MIPS), which consolidates the Meaningful Use Program, the Physician Quality Reporting System and the Value-Based Modifier. MIPS will assess the performance of eligible professionals (EPs) in four categories: quality, resource use, EHR Meaningful Use and clinical practice improvement.

EPs still will need to use a certified electronic health record. They'll receive a composite score in the four categories, and will potentially receive negative or positive payment adjustments. EPs participating in an alternative payment model (APM) and meeting those requirements will be excluded from the MIPS assessment and most EHR requirements. 

The payment adjustments for failing to meet the Meaningful Use requirements will sunset at the end of 2017. It is unclear whether this provision applies only to EPs.

The proposed legislation also requires EHRs to be interoperable by 2017 and prohibits providers from deliberately blocking information sharing with other EHR vendor products. What's more, it calls on the U.S. Department of Health & Human Services to identify and list clinical decision support mechanisms to be used to consult appropriate use criteria in imaging.

This is not the first time that Congress has expressed interest in reassessing the Meaningful Use program. Several Senators had also recently recommended that any changes to the SGR include an amendment requiring EHRs to be interoperable by 2017. The proposed deal now will go before the entire Congress for deliberation. The law temporarily presenting an SGR payment reduction expires in March 2014.

To learn more:
- read the Senate Finance Committee's announcement
- here's a detailed summary of the bill (courtesy of Brian Ahier)

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