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Dr. Richard Loomis, MD · Apr 29, 2016

MACRA update: HHS proposes plan to replace Meaningful Use with Advancing Care Information in 2017

Practice Fusion is committed to helping all our providers meet quality reporting requirements and stay up to date on the latest policy changes. In this post, Chief Medical Officer Dr. Richard Loomis weighs in on the proposed MACRA rule that will replace Meaningful Use, which HHS released April 27. We’ll share additional insights as we continue our analysis of the proposed rule.

As reported in January, the department of Health and Human Services (HHS) is planning to end the Meaningful Use program for Medicare physicians. This week HHS released a proposed rule for how Meaningful Use will be replaced under the Medicare Access and CHIP Reauthorization Act (MACRA) law, which repealed the sustainable growth rate formula in 2015.

Although we’re still analyzing the 962-page proposed rule, I’m pleased to see that HHS is taking steps to simplify reporting while offering greater flexibility to a broad range of practice settings and specialties. Reporting requirements for existing incentive programs including Meaningful Use and PQRS are onerous and inflexible. The burden for a provider to participate in existing programs each year is roughly $40,000 in administrative reporting costs alone. While the proposed rule is complex, and does add additional reporting requirements as part of the transition to fee for value, there are welcome changes to the Meaningful Use program that will help simplify that part of the attestation process going forward.

With its consolidation into MACRA, the Meaningful Use Incentive program (MU) will become the Advancing Care Information component of the Merit-Based Incentive Payments System (MIPS). In addition, the rule proposes changes to the existing program that streamline reporting requirements in multiple ways, including:

  • Removing two measures: CPOE and CDS alerts. The rationale is that these two attestation items in Stage 2 are consistently above 90% and therefore already widely adopted.
  • Simplifying reporting requirements for two MU measures to a simple yes/no attestation. Providers will no longer need to track the numerator and denominator for the Health Information Exchange and Public Health and Clinical Data Registry reporting measures. This reduces the total number of MU measures with numerator and denominator reporting requirements — there are now four.
  • Eliminating the 90-day reporting period for first-time attestations. Instead, CMS will require a full calendar year reporting period for all stages and all providers. This eliminates a fairly confusing aspect of attestation.

Although reporting may be simplified, the expanded scope of the program will appear daunting for most practices. The nuances for scoring and compensation are detailed across several hundred pages of the MACRA proposed rule, and will take time for the industry to digest, assess and comment.

I’m looking forward to working with our team to deliver the best tools to participate in quality reporting while also offering you flexibility in how you continue the transition to fee for value under the new MACRA requirements. For Practice Fusion it’s not enough to become certified — we aspire to ensure providers can excel in these programs and by doing so improve care for their patients.

We’ll keep you updated as we continue to analyze the MACRA proposed rule and what it means for your practice.

The entire proposed rule can be found here.

—Dr. Richard Loomis, MD, Vice President and Chief Medical Officer, Practice Fusion