Healthcare stakeholders mixed on MACRA rule's MU implications


Stakeholders throughout the healthcare industry shared mixed feelings on the Centers for Medicare & Medicaid Services attempt to overhaul the Meaningful Use program for doctors via proposed rules implementing the Medicare Access and CHIP Reauthorization Act of 2015, unveiled Wednesday.

For instance, Robert Tennant, director of health information technology policy for the Medical Group Management Association, told FierceHealthIT in an email that while MGMA appreciates the increased flexibility and reduced thresholds for many of the measures touted by CMS Acting Administrator Andy Slavitt, it still has concerns about some of the requirements.

"We have questions regarding the Base Score approach and the decision by the agency to mandate full-year reporting," said Tennant, who added that MGMA continues to review the proposed rule.

What's more, John Halamka, CIO for Boston-based Beth Israel Deaconess Medical Center and former co-chair of the Office of the National Coordinator for Health IT's Standards Committee, questioned the decision to have physicians use 2015 certified technology; National Coordinator Karen DeSalvo called 2015 edition certification "foundational" to the proposed MACRA rule.

"The 2015 rule is a kitchen sink of standards, many of which are not ready for production deployment," Halamka said in a blog post. "The [2015] rule is an example of regulatory overambition--instead of narrowing the scope to specific goals or workflows, it includes a cornucopia of use cases unrelated to Meaningful Use."

He suggests that CMS instead use the Standards Advisory concept.

Still, Halamka was not entirely critical of the proposed rule. He, like Tennant, lauded the reduced documentation burden and the increased flexibility.

The American Medical Association, the American Medical Informatics Association and the College of Healthcare Information Management Executives all, too, had good things to say about the rule. AMA President Steven Stack, in a statement, said that "it appears CMS has made significant improvements by recasting the EHR Meaningful Use program and by reducing quality reporting burdens."

AMIA noted that a renewed focus on patient data access, patient engagement, care coordination and health data exchange will help both providers and policymakers take advantage of participation, enabling them to learn from their experiences as opposed to simply taking steps to earn a grade.

"We are also encouraged by CMS's proposals to use the clinical performance improvement activities [CPIA] to enhance the use of certified EHR technology," AMIA noted. "We firmly believe that to be successful in MIPS and APMs, a new generation of workforce skills and education will be needed ... we see CPIA options that encourage physicians and other clinicians to leverage informatics tools to improve practice as a step in the right direction."

And despite the fact the rule primarily impacts Medicare physicians, CHIME President CEO Russell Branzell said in a statement that elements focusing on data blocking are of "significant interest" to the group's members.

"We are encouraged that CMS Acting Administrator Andy Slavitt said the agency will continue to meet with hospital officials to create alignment across health IT programs," Branzell said.

To learn more:
- read Halamka's blog post
- check out Stack's statement