CMS Stresses Meaning Behind EHR Measures

CMS is letting physicians know it is ready to move beyond meaningful use of an EHR and into meaningful reporting of data to improve healthcare.

Appearing at the Healthcare Information and Management Systems Society (HIMSS) annual conference in Las Vegas, a top CMS official provided updates on the EHR Incentive Program as it sunsets to make way for the Merit-based Incentive Payment System (MIPS).  Created through the Medicare Access and CHIP Reauthorization Act (MACRA), MIPS will use meaningful use of certified EHR technology as one of four criteria to determine reimbursement to physicians for quality-based care.

Elisabeth Myers, senior policy advisor for CMS’ center for clinical standards and quality, said the federal agency was already looking at improving the meaningful use program prior to the passage of MACRA, “to realign … and readjust the program” for the long-term goal of supporting the use of health IT.

“We want to reduce the burden on providers and drive [the program] to the use of technology, not just the capture of data,” Myers said.

CMS didn’t have much to say about the MIPS program overall, except that the agency is watching its development carefully in the coming months, as the rules to implement it become finalized, to see how it will affect the EHR Incentive Program.

But the agency did outline the next two years of reporting for physicians, emphasizing that while meaningful use is going away, it is very much still mandated in the present. The goal, officials say, is to help and not hurt physicians in using their EHRs to the fullest capacity for patient care. As of December 2015, CMS noted, more than 559,000 eligible professionals, eligible hospitals, and critical access hospitals were registered in the incentive programs and more than $21 billion in Medicare payments were issued.

In the release of the 2015 EHR final rule in October of last year, CMS modified some of the objectives and programs they heard were burdening physicians. One such measure was patient electronic access where the original guidance was that 50 percent of a physician’s panel had to be provided access to records and 5 percent had to view, download, or transmit that data to a third party via the EHR. The modified rule changed that to just one patient required to take action in 2015 and 2016, increasing to 5 percent of the patient panel by 2017.

Myers said the goal of the objective was to never regulate how EHR systems function, but rather that a patient can get the information they want, thus “removing the barriers to their own data.” Myers said the data CMS collected initially from providers showed great variation in meeting the goal and “showed us there is something going on here that needs to mature,” necessitating the change to just one patient.

The same is true for the secure messaging objective, which was modified along the same lines as electronic access (one patient in 2015 and 2016; 5 percent in 2017) to reduce the burden on providers, Myers said.

“The biggest feedback we heard [from providers] was ‘this isn’t giving me value,” she noted. CMS’ goal, Myers said, was that the patient has a way to communicate in a timely manner. “We want to see the communication loop,” she said.