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MACRA, the End of Meaningful Use, and Beyond

   August 01, 2016

McCleese welcomes the consolidation of overlapping quality measures outlined both in meaningful use stage 3 and in the proposed MACRA rule. At present, "we've got to report the same thing in three or four different formats to different agencies that need the same data," he says.

Also challenging McCleese under the current meaningful use program: MACRA and meaningful use, going forward, require electronic reporting of quality measures, but various EHR software, including the Meditech EHR software in use at St. Claire, isn't yet set up to automate that reporting. Instead, St. Claire staff must export the data from the EHR to spreadsheets and prepare it for electronic submission, adding to a cumbersome process.

Some broad governance implications of the move from meaningful use to the value-based payment world of MACRA, MIPS, and the APMs is also coming into focus for McCleese. Fast fading are the days of CIOs managing the meaningful use program in relative isolation from the rest of the executive team.

"It is going to have to be a multidisciplinary governance area, in our case, that will heavily involve our CMO and vice president for quality, and we're also going to have to bring in nursing," McCleese says.

McCleese also echoes the concerns in the industry that the MACRA legislation itself, on top of the HITECH legislation that created the meaningful use program, requires physicians to report on too many quality measures too soon. "If we try to get all of them, I'm not sure we're going to do a very good job at any of them," he says. "If we focus on five measures in each of the specialties, then 10, then 15, then 20, we'd be better off."

Karen Wilding, director of IT operations at the 12-hospital University of Maryland Medical System, headquartered in Baltimore, says, "Meaningful use objectives are going to remain. We are still expected to adhere and be successful. They are part of our ongoing operations and expectations, and now we have an ability to build on what we've already been successful on previously."

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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