The Centers for Medicare & Medicaid Services (CMS) has proposed changes to the Meaningful Use program that are intended to relieve physician reporting burdens. Those changes include reducing the 2016 reporting period to 90 days.
Based on feedback from the health care community, the proposed changes “better support physicians in providing beneficiaries with the right care at the right time,” CMS Acting Administrator Andy Slavitt said in a press release. These changes were detailed in the 2017 Hospital Outpatient Prospective Payment System (OPPS) proposed rule released last week.
What changed?
The AMA continues to drive home the message that the current problems of the Meaningful Use program must not be carried forward—and the changes recently proposed in the OPPS to Meaningful Use are a good start.
Physicians around the country are expecting similar thoughtfulness from CMS about reducing burdens under Medicare’s Merit-based Incentive Payment System (MIPS) when the Medicare Access and CHIP Reauthorization Act (MACRA) final rule is released in the fall.
Here are three key changes to Meaningful Use in the proposed rule:
90-day reporting period in 2016
The OPPS proposed rule would allow physicians, hospitals and critical access hospitals (CAH) to use any 90-day, continuous reporting period between Jan. 1 and Dec. 31, 2016, rather than the full calendar year reporting period currently required under Meaningful Use.
CMS has also proposed a 90-day electronic health record (EHR) reporting period for clinical quality measures. However, the rule does not make any changes to the Physician Quality Reporting System (PQRS) reporting period, so if you are using clinical quality measures to satisfy PQRS reporting, you will still need to report clinical quality measures for a full calendar year in 2017.
Hardship exception for new participants
CMS proposed 2017 as the first performance period for MACRA. But 2017 is also the last year first-time Meaningful Use participants may attest to avoid penalties in 2018. The result is that a first-time participant would be required to report for both Meaningful Use and the Advancing Care Information (ACI) category under MIPS to avoid a payment adjustment 2018.
In the OPPS proposed rule, however, CMS stated its intent to provide first-time participating physicians the opportunity to apply for a significant hardship exception from the 2018 payment adjustment.
Physicians wishing to apply for the hardship exception will need to submit an application by Oct. 1, 2017, to demonstrate their eligibility. While the application has not yet been released, CMS indicates that it will require an explanation of why, based on the physician’s particular circumstances, meeting requirements of the Meaningful Use program for the first time in 2017 while also reporting on measures for the ACI performance category of MIPS would result in significant hardship.
The AMA pressed CMS for the hardship exception for 2017 and will continue to work toward making this process simple for physicians.
Changes to measures and threshold reductions
CMS is also proposing to eliminate or reduce objectives and measures for eligible hospitals and CAHs attesting under the Meaningful Use program for calendar year 2017 and subsequent years.
Some of these changes are intended to help align the hospital Meaningful Use program with MIPS when it is implemented beginning next year.
For example, CMS proposed to eliminate the clinical decision support and computerized physician order entry objectives and measures for eligible hospitals and CAHs. Additionally, the threshold for the health information exchange measure requiring physicians to create a summary of care will be reduced from more than 50 percent to more than 10 percent.
The secure messaging threshold for eligible hospitals and CAHs will be reduced from more than 25 percent to more than 5 percent in Stage 3 because patients who are in the hospital for an isolated incident may not have a reason to follow up with the hospital via secure messaging.
For more information on these proposed changes, take a look at the OPPS proposed rule fact sheet from CMS
