Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt says he intends to end the controversial meaningful use program.

Meaningful Use To Be Replaced In 2016, Says CMS Administrator

Written by Ronny Bachrach on January 20, 2016. Posted in Digital Radiography and PACS, Hardware

Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt says he intends to end the controversial meaningful use program, reported Healthcare IT News. Slavitt made the remarks during a Jan. 11 presentation at the J.P. Morgan Healthcare Conference in San Francisco.

"The meaningful use program as it has existed, will now be effectively over and replaced with something better," Slavitt said. "Since late last year we have been working side by side with physician organizations across many communities – including with great advocacy from the AMA – and have listened to the needs and concerns of many."

An Imperfect Standard
The Health Information Technology for Economic and Clinical Health Act established the meaningful use program in 2009 to promote wider adoption of electronic health records and interoperable health information technology. Physicians who met adoption benchmarks set out by the three-stage program would qualify for financial incentives while those who failed would incur penalties. According to the Congressional Budget Office, only 12 percent of U.S. physicians used electronic information systems at the time.

Meaningful use garnered criticism from the start. Many health care professionals recognized that widespread EHR adoption was critical to the future of medicine, but argued that threatening physicians with financial penalties was the wrong way to go about promoting new technology, reported The Washington Post. Others found the idea of spending billions of dollars on the adoption of existing information systems foolish. In 2009, Dr. Kenneth Mandl and Dr. Isaac Kohane, two health information experts from Children's Hospital Boston, published an article in the New England Journal of Medicine that encapsulated this concern, reported The New York Times.

"If the government's money goes to cement the current technology in place we will have a very hard time innovating in health care reform," Mandl said in an interview with the paper.

Unique Workflows
The meaningful use program posed unique challenges for medical imaging professionals, as many of its adoption rules applied to information systems not normally found in the average radiological workflow – for example, electronic prescribing networks. This meant personnel from the Certification Commission for Health Information Technology might have trouble evaluating program compliance within the medical imaging specialty. Additionally, many radiological departments and practices already used interoperable health information technology like PACS and RIS.

In 2009, the American College of Radiology expressed these concerns in a letter to the Office of the National Coordinator for Health Information Technology. By 2011, when the rules for stage one were finalized, most radiologists were eligible to receive incentives under meaningful use, reported Radiology Today.

According to Tech Target, the final rules for stage two, published in 2012, included provisions for radiologists. Specifically, stage two specified that medical imaging professionals must make scans and accompanying image information available to patients within 24 hours of their appointment. 

Looking To The Future
Many physicians welcomed Slavitt's announcement. In October, soon after the CMS released the final rules for stage three of meaningful use, the American Medical Association and other health care organizations criticized the direction of the program, reported Modern Healthcare. These groups called out its all-or-nothing approach to assessing compliance and stringent order-entry criteria, and argued that meaningful use was adversely affecting care outcomes.

"Many of the [meaningful use] requirements were designed to increase patient choice and quality care," said the AMA in a letter to the CMS. "Unfortunately, many of these requirements, especially those in the latter phases of the [meaningful use] program, are having the opposite effect. Oftentimes the requirements decrease the efficiency of patient visits."

In his speech at the J.P. Morgan Healthcare Conference, Slavitt specifically mentioned these concerns and promised a more streamlined replacement, reported Becker's Health IT and CIO Review. The CMS administrator said he wanted to ease the compliance burden physicians operating under meaningful use now shoulder. According to Politico, 209,000 physicians and care providers were assessed for penalties totaling around $600 million in 2015.

Slavitt also said the meaningful use replacement will focus on care outcomes rather than industry-wide technology adoption. The AMA praised Slavitt's plan.

"His leadership is a model for how Washington should work," AMA President Dr. Steve Stack said. "He listened to working physicians who said the meaningful use program made them choose between following Byzantine technological requirements and spending more time with their patients. This is a win for patients, physicians and common sense." 

Ronny Bachrach

Ronny Bachrach

Marketing Director at Viztek LLC
Responsible for all marketing activities including, press, advertising, trade show coordination, website management, dealer and customer communications.
Ronny Bachrach
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