The Centers for Medicare & Medicaid Services final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA) maintains many of the provisions outlined in its proposed rule regarding the reporting and use of certified electronic health record technology.
The rule, released Oct. 14, finalizes the payment programs for physicians under MACRA’s advanced alternative payment models and the Merit-Based Incentive Payment System (MIPS), which consolidates components of the Meaningful Use program, the Physician Quality Reporting System and the physician value-based payment modifier. Under MIPS, eligible clinicians will be measured on quality, resource use, clinical practice improvements and meaningful use of certified EHR technology, now referred to as “advancing care information.”
In a press call, CMS Acting Administrator Andy Slavitt said that the number of measures have been cut in half from the proposed rule. The proposed rule recommended 11 measures in the advancing care information performance category, reduced from 18 in the Meaningful Use program; the final rule reduces the number of measures in that category further to five.
CMS retained many of the components of the proposed rule in the final rule, including:
- Physicians will have more flexibility in selecting the measures on which to report
- CMS is moving away from the "all-or-nothing" EHR measurement; instead, clinicians would receive a base score of 50 percent for reporting the required measures regarding their use of EHR technology, and can get a bonus for reporting on optional measures
- Physicians will need to attest that they are not engaged in information blocking and that they provide patients with access to their data
The rule sunsets payment adjustments under the current Meaningful Use program.
In a related blog post, Slavitt explained further how MIPS changes reporting and scorekeeping:
“[W]e are simplifying requirements for the two quality components of the program--the quality measures and practice-specific improvement activities," he said. "Second, we are moving to align the measurement of certified EHR technology with the improvement activities. This will begin 2017 with a portion of the Advancing Care Information measures; we intend to align more of these measures with quality in later years, to further ensure that certified EHRs are being used to support high-quality care.
"We also narrowed the focus to those measures that support hospitals and physicians safely and securely exchanging information, and we expect both registries and certified EHRs to move to make reporting more 'push button,' making such reporting easier for clinicians," he continued.
The rule is effective Jan. 1, 2017, although 2017 will be a transition year. CMS also will accept comments on the final rule for 60 days.