Meaningful Use Is Going to Be Replaced – #JPM16

Big news came out today during the JP Morgan annual healthcare conference in San Francisco. Andy Slavitt, acting administrator of CMS, live tweeted his own talk at the event including this bombshell:


Technically meaningful use is not quite over, but it’s heading that way. We always read about lame duck head coaches in sports. I guess this is the version of a lame duck government program? Of course, this is just coming from the acting administrator of CMS. It’s not yet law. So, all those working on meaningful use reports, keep working.

The end of meaningful use as we know it will be generally welcome news to most in healthcare. Although, I’m sure that most will also take it with a grain of salt. Many in healthcare likely worry that the “something better” that replaces meaningful use and MACRA will actually be something worse. The cynics might argue that nothing could be worse, but I’ve never seen the government back down from that challenge.

What interests me is what levers they have available to them to be able to make changes. Can they do it without congressional action? Are doctors angry enough that congress will take action? What will happen to the remaining $10-20 billion allocated to meaningful use? What will hospitals and doctors that were counting on the meaningful use money do? Will they not get it anymore or will it be available in a new program? Obviously, there are more questions than answers at this point.

All in all, I’m glad to hear that Andy Slavitt is open to change. I suggested they blow up meaningful use a couple years ago.

Andy also did a tweetstorm to outline the 4 themes for reforming the MACRA and post-MU tech program:

These all seem surprisingly reasonable and mirror many of the comments I hear from doctors. However, the challenge is always in the implementation of these ideas. Some of them are very hard to track and reward. I can’t argue with the principles though. They highlight some of the major challenges associated with healthcare tech. It’s going to take some time to infuse entrepreneurship instead of regulation back into the EHR world, but these guidelines are a good step towards that effort.

UPDATE: Here’s the full text of Andy Slavitt’s talk at the JP Morgan Healthcare Conference.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

10 Comments

  • Hey John,
    We do hate to say “I told you so” but we all knew MU has been dead for awhile. It has effectively driven many out of practice and was a huge impediment to the physician patient relationship. Those of us that are survived and lived through this dark period, will forever be scarred. As for the ‘next big better idea” from CMS, I could not agree more that it scares the hell out of me. Look what it took to get MU killed, and the ENTIRE time, CMS and ONC would pump out deceptive stats and sending out backslapping tweets and comments, all the while using puffery language on triple aim BS. Then Boom, mid program, the director publicly reverses course (more on this later).

    Thanks for listening to some of us front liners and putting our concerns out there. I wonder what finally clicked in their heads that MU is not working? Were there mass defections from Medicare? Significant numbers of providers leaving practice? I can tell you that from my front line experience, I see many leaving and none coming back. The negative comments about MU became too loud? These policy wonks actually had to see a physician and watch them struggle with EHR right in from of them? Costs going up with no improvement or worsening outcomes? I just wonder. There has to be more to that story. I got a feeling that they saw something very serious happening and they rapidly pulled the plug as they never act before a crisis, only when one is imminent/occurring or usually way too late. This action appears to be VERY sudden and unusual, further CMS just released 2 big MU regulations (Stage 3 and Cert) over the past few months. I smell smoke here. Something is amiss, a tweetstorm to end MU? Thats how it works now? And as you state, there are significant policy changes that have to occur for MU to end, including congressional action. I would suggest that you journalist types pin these guys down on what happened to make them jump off this MU sinking ship? Maybe we can understand how to prevent such a regulatory disaster in the future.

  • The interesting aspect of this is how many wasted hours have been spent by ONC, their associated workgroups and task forces, and thousands of vendors and consultants on the planning and preparation for Stage 3. My guess is this effort numbers in the millions of hours, and hundreds of millions of dollars, based on the number of people involved. At least some of the smaller vendors who would not have been able to comply, might actually be able to survive now.

  • meltoots,
    I’m not sure we’ll ever know. Plus, like most things in life, it probably wasn’t just one thing. Saying that it’s one thing makes for a nice headline, but the reality is that there are always a lot of moving parts.

    Mike,
    I agree on the waste of time on MU stage 3, etc. However, I’m afraid that all that work will just reappear in a new program. I’d love for them to just scrape it and start from square one. I don’t think they legally can do that (without congressional action) and it’s not in their nature to do it. Even if they threw out half of it, it would be better. We’ll see.

    Depending on if they really scrape and limit MU, you’re right that it could allow a number of smaller vendors to survive. It will also open the opportunity for entrepreneurs to start efforts to displace the current crop. With meaningful use in place, no one in their right mind would try and compete.

  • The reported “death of MU” is the first big urban rumor of the year. The CMS EHR Incentive program is winding down, as was forecast by the timeline. However the “MU of CEHRT” makes up 25% of the coming Medicare Part B reimbursement scheme, MIPS. Under MIPS the potential penalties could be substantially higher and make EPs wish for the “good old days” of 2011 – 2016.

    Jim Tate

  • Jim,
    Agreed. That’s why I didn’t report it being dead. I just said it would be replaced. It’s also why I warned that the replacement might be worse than the original.

  • On thing that is NOT going to be replaced is the ONC 2015 Edition Certification.

    Just this week ONC released the final version of the test procedures that need to be followed in order for EHR vendors to get this certification; and either MU funding or MACRA funding for their clients.

    Here is a link to the some info on the final test methods…

    http://www.theusabilitypeople.com/article/onc-has-posted-final-2015-edition-test-method

    (Disclaimer – I was/am on the ONC HITPC committee work group that advised on the Usability portion of the 2015 Edition Certification)

  • Bennett,
    You bring up an interesting point about certification. I guess I’m not as confident as you about EHR certification sticking around. Is there a reason you’re so confident about it not being removed?

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