CMS Acting Administrator Andy Slavitt recently took center stage during the J.P. Morgan 34th Annual Healthcare Conference in San Francisco for what could have been a routine speech about upcoming health care policies aimed at an interested stakeholder audience.
However, a few minutes into his remarks, available in their entirety in a CMS blog(blog.cms.gov) posted on Jan. 12, Slavitt rocked the U.S. health care world with these words:
"We are now in the process of ending meaningful use and moving to a new regime culminating with the MACRA (Medicare Access and CHIP Reauthorization Act) implementation. The meaningful use program, as it has existed, will now be effectively over and replaced with something better."
Judging from the immediate media interest, Slavitt's announcement caught many people off guard.
Count the AAFP among those surprised by the news, even though Academy leadership has been relentless over the past many months in demanding that CMS halt a burdensome program that was driving family physicians away from an initiative intended to increase physician use of -- and reliance on -- health IT.
In fact, as recently as December, AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., declared meaningful use "a program in crisis."
After this week's announcement, the AAFP wasted no time in crafting a response to CMS that was both complimentary and cautious.
In a Jan. 13 letter to Slavitt,(2 page PDF) the Academy confirmed that it shares CMS' assessment that the meaningful use program has outlived its usefulness and should be replaced with something better.
Wergin commended Slavitt for recognizing that CMS had lost the "hearts and minds" of America's physicians. "This statement will have a positive impact on our members who are facing the day-to-day frustrations of the administrative complexity of practicing medicine," he said.
However, bold words "must be followed with thoughtful and meaningful actions," Wergin cautioned.
He acknowledged agreement between the AAFP and CMS that the national health information strategy must shift.
"We call on you and your staff to assure that not only the name of the program will change but that the current criteria will be definitively replaced," said Wergin.
In short, the AAFP called for a fresh start for a program that for too long has added more burden than benefit to patient care, been misaligned with the requirements envisioned in the Merit-based Incentive Payment System and needed a focus on interoperability to further accelerate work in that domain.
"Primary care is a finite resource" that is undervalued and lacks adequate resources, Wergin noted.
"Our patients and our nation desperately need health care policy to enhance efficiency, complement workflow and improve our ability to deliver the best patient care. We are not alone in believing the current meaningful use program and its criteria do not embody those principles," said Wergin.
He offered the AAFP's assistance in helping CMS develop new health IT policy that would
- accelerate robust interoperability to support continuity of care and care coordination,
- eliminate burdensome requirements that siphon limited resources away from patient care, and
- integrate any new policy with numerous other federal initiatives and regulations with an aim toward improving health care rather than interfering with physicians' efforts.
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Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)