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MACRA, the End of Meaningful Use, and Beyond

By smace@healthleadersmedia.com  
   August 01, 2016

But on the physician side, as spelled out in the MACRA legislation, meaningful use was indeed being replaced by a program given the new name Advancing Care Information (ACI), which is just one component in the larger matrix of CMS physician incentive programs that kick in January 2017 and that will trigger increased or decreased payment adjustments starting in 2019.

Those incentive programs, known as the Merit-Based Incentive Payment System (MIPS), and Alternative Payment Models (APM) will start to move all physicians toward a goal expressed in the 2010 Affordable Care Act: for physicians to be reimbursed not for services rendered, but instead for outcomes.

How to get from fee-for-service to value-based care is still a journey of many unknown turns for providers, not all of whom are convinced that ACI will do away with the busywork physicians had to perform under meaningful use.

"Based on what I'm seeing so far of MACRA, I think we're still going to be clicking a lot of boxes" in 2017, says Randy McCleese, vice president of information services and chief information officer at St. Claire Regional Medical Center, a 159-licensed-bed Morehead, Kentucky, hospital with 100 physicians, six primary care clinics, and two specialty clinics.

Like many of his executive counterparts, McCleese, a past board chairman of the College of Healthcare Information Management Executives, spent the weeks following the release of the MACRA NPRM on numerous conference calls, as the industry struggles to make sense of the proposed rule and chart a path forward. "We, as an organization, are just starting to get our hands around MACRA," he says.

Some of the organization's physicians believe that MACRA means the end of meaningful use. "The meaningful use program is just being rolled into and consumed into something bigger and something broader," McCleese says.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.


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