MACRA, the End of Meaningful Use, and Beyond
The move from meaningful use to the value-based payment world of MACRA, MIPS, and the APMs is coming into focus.
This article first appeared in the July/August 2016 issue of HealthLeaders magazine.
Meaningful use as we knew it changed on April 14, 2015. And what it's becoming is still being discerned by physicians, healthcare executives, and the industry at large.
On that date, a large bipartisan majority in Congress passed the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. MACRA permanently repeals the flawed Sustainable Growth Rate formula for determining Medicare payments for clinicians' services. According to the Centers for Medicare & Medicaid Services, it also establishes a new framework for rewarding clinicians for value over volume, and streamlines other existing quality-reporting programs into a single new system.
But before any of that can occur, the entire healthcare industry must gain a better understanding of MACRA, policies and procedures must be implemented, and technology needs a serious upgrade. In January 2016, Acting CMS Administrator Andy Slavitt created some confusion in the industry by describing MACRA as the end of meaningful use as we knew it, when, in fact, later clarifications more accurately described it as an evolution of meaningful use for physicians as expressed by Congress in the MACRA legislation.
The true scope of MACRA became clearer on April 25, 2016, when CMS released the 962-page Notice of Proposed Rulemaking (NPRM) for MACRA, and opened a two-month comment period. As Slavitt had to emphasize in January, the meaningful use program would continue uninterrupted for hospitals. In fact, stage 3 of meaningful use for hospitals, which is also a component of moving toward value-based care, is due to commence in 2017 for early adopters, and in 2018 for hospitals in general.