Does meaningful use have a meaningful future?

The American Recovery and Reinvestment Act of 2009 created an electronic health record (“EHR”) incentive program, commonly referred to as “Meaningful Use.” The program pays incentives to certain providers and hospitals to implement and make meaningful use of certified EHR technology. The three main components of Meaningful Use include: (1) the use of certified EHR technology in a “meaningful” manner; (2) the electronic exchange of health care information to improve the quality of care patients receive; and (3) the use of certified EHR technology to submit clinical quality and other measures.

In application, providers and hospitals have to meet certain Meaningful Use criteria or measures to be eligible to receive federal funds from the Medicare EHR Incentive Program, the Medicaid EHR Incentive Program, or both. Although Meaningful Use is voluntary, the penalties and reimbursements associated with the program provide a strong incentive for providers to participate.
Meaningful Use has been divided into three stages: Stage One, which focused on promoting the adoption of EHRs; Stage Two, which increased the criteria of compliance and promoted more support, care-coordination, and patient engagement rules; and Stage Three, which focused on increasing health information exchange, as well as improving previous guidelines introduced in Stages One and Two.

The (Realistic) Future of Meaningful Use
In January of 2016, Andy Slavitt, the acting administrator for CMS, suggested that Meaningful Use will now be effectively over and replaced with something better. Shortly thereafter, Karen DeSalvo, the acting assistant secretary for health in the U.S. Department of Health and Human Services, qualified Slavitt’s statements, indicating that Meaningful Use is not dead, although it may take a different form than the initial stages of the program.

Further muddying the waters is the recent release of the proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule. Irrespective of any changes to Meaningful Use by way of MACRA, it is clear that the federal government is deeply concerned and committed to improving population health outcomes, engaging patients, and increasing transparency, while simultaneously trying to increase patient privacy and the security of patients’ protected health information. Although experts will need time to digest the 962 page MACRA rule1, it appears at first glance that, “starting in 2017, meaningful use will now be dubbed the ‘Advancing Care Information (ACI)’ program for Medicare-participating doctors, and will account for 25 percent of an eligible physician’s (EP) total score under the Merit-based Incentive Payment System (MIPS) in the first year2.”

Thus, it is unclear at this point whether Meaningful Use is gone, or whether it has simply been rebranded. Regardless of the program’s name, CMS’s vision for the future includes focusing on quality of care, effective resource usage, and the continued adoption of certified EHR technology.

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  2. See Rajiv Leventhal, Another “Is Meaningful Use Dead” Debate? You Don’t Say!, Healthcare Informatics (May 05, 2016, 12:40PM)