Providers press HHS to restructure MU, flawed Stage 3 rule

On the heels of CMS Acting Administrator Andy Slavitt’s declaration last week that the Meaningful Use program as it has existed is effectively over, 31 healthcare providers have sent a letter to Health and Human Services Secretary Sylvia Burwell expressing their concerns with the “current, ineffectual” MU structure.

By using MU as an enforcement tool, there has been little improvement in data exchange.The organizations—including Beth Israel Deaconess Medical Center, Emory Healthcare, Geisinger Health System, Intermountain Healthcare, and Weill Cornell Medicine—late last week urged HHS to restructure the MU program to better fit the industry’s transition to value-based care and to focus on improving the interoperability and usability of electronic health records. Specifically, the providers see the Stage 3 final rule as being counterproductive to reaching these goals.

“The Stage 3 final rule, like its predecessor rules, is too focused on pass-fail requirements and lacks emphasis on outcomes,” states the Jan. 14 letter to Burwell. “By maintaining this flawed structure, we do not believe Stage 3 will support movement towards more innovative care models or encourage continued participation. Stage 3 also fails to prioritize foundational issues to improve interoperability, which is imperative for our medical communities to function at their highest levels.”

Further, the providers argue that Stage 2 EHR design requirements have been a “fundamental drag on interoperability” and that Stage 3 will only serve to worsen these problems.

“By using MU as an enforcement tool, there has been little improvement in data exchange,” claim the healthcare organizations. “Patient medical information is also shoehorned into a format that was designed for MU measures, and not in a way that accommodates the needs of physicians and patients. Addressing these issues must be a priority, but what is required in the Stage 3 rule limits progress while diverting needed resources. Regrettably, we believe the Stage 3 final rule maintains the same problematic measures in Stage 2 and will not put the nation on a path to reach these goals.”

Also See: HIT Executives Anxious to See Details of Shift from MU

However, given Slavitt’s remarks last week at the J.P. Morgan annual healthcare conference that the Meaningful Use program will be ending some time in 2016, the status of Stage 3 of the MU program remains in question. While CMS is in the process of ending Meaningful Use and implementing the Medicare Access and CHIP Reauthorization Act, including the Merit-Based Incentive Payment System for providers, Slavitt emphasized that the agency is “deadly serious” about interoperability.

Healthcare organizations will have to wait to hear what CMS plans to do to foster greater health information exchange. Details are slated for release over the next few months.

For now, Slavitt’s Jan. 11 speech attempted to allay providers’ concerns regarding the fact that the Meaningful Use program has been the driving factor behind the design of EHR technology, which they say lacks technical innovations necessary for outcomes-based care.

The CMS chief said that the agency wants to “move away from rewarding providers for the use of technology and towards the outcome they achieve with their patients” while enabling providers to “customize their goals so tech companies can build around the individual practice needs, not the needs of the government” so that EHR technology is “user-centered and support physicians, not distract them.”