Stakeholders to CMS: MU changes in OPPS rule good, but not good enough

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Many of the proposed changes to the Meaningful Use program contained in the proposed hospital outpatient prospective payment (OPPS) rule for 2017 remain overly burdensome on providers, according to industry leaders providing comment on the rule.  

Some of the proposed changes, such as requiring only a 90-day reporting period for 2016, were enthusiastically supported. The Centers for Medicare & Medicaid Services' proposed reductions to some of the thresholds of the objectives and measurements in the Meaningful Use program also were appreciated by commenters, but not without caveats.

For instance, Health IT Now noted that CMS was missing an opportunity by merely adjusting the threshold of a few specific measures, and suggested that it remove measures from the Meaningful Use program that are not directly related to reaching the goal of interoperability. The College of Healthcare Information Management Executives (CHIME) suggested that CMS reconsider full-year reporting for electronic clinical quality measures (eCQMs).

Many of the comments were reiterations of concerns previously articulated. Stakeholders still want more flexibility in the Meaningful Use program itself, such as 90-day reporting in 2017, postponing Stage 3 of the program until no sooner than 2019 and elimination of the all-or-nothing approach, all advocated by the American Hospital Association. 

Several stakeholders recommended expansion of the hardship exceptions, such as for new participants transitioning to the Merit-Based Incentive Program System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA), and for providers who change vendors during a reporting period.

Commenters also strongly recommended that the Medicare and Medicaid EHR Incentive programs be more aligned, as well as the Meaningful Use program, with the new MIPS program. There also was concern about CMS’ proposal to rely on functionalities that were not proven or mature.  

AMIA additionally suggested that CMS not update Meaningful Use requirements until 2021 for consistency’s sake, and so that clinicians can optimize their technology.