On Thursday, the American Medical Association (AMA) and 41 medical societies have backed Sen. Lamar Alexander (R-Tenn.) in urging the administration to delay Meaningful Use Stage 3 in light of pivotal changes to Medicare. The coalition of physician organizations firmly believes that locking in Stage 3 rules for the Meaningful Use program would be a detrimental step that undermines the implementation of Medicare payment reforms.
In letters delivered to the Secretary of Health and Human Services Sylvia Burwell and Office of Management and Budget Director Shaun Donovan, the physician organizations stated:
“The physician community is extremely dismayed by recent press reports that the Final Modifications Rule and the Final MU Stage 3 Rule have been combined and this rule is now under review at the Office of Management and Budget (OMB). If the administration finalizes the proposed MU Stage 3 regulation now, vendors will create software that will lock-in problematic technology, which physicians and patients will be living with for years to come.
The proposed MU Stage 3 regulation exacerbates problematic policies of MU Stage 2 by continuing to “count” physicians’ compliance with one-size-fits-all objectives rather than focusing on the clinical activities that should support differences in medical practices and patient care. We believe Stage 3 takes a drastic step backwards from the proposed improvements of the Modifications Rule.
Moreover, the proposed MU Stage 3 regulation was developed prior to and without consideration of the changes enacted by the Medicare Access and Chip Reauthorization Act (MACRA). Yet, the MU program will play a vital role in both the new MIPS payment system and the development of APMs. The administration should therefore pause MU Stage 3 and reevaluate the program in light of these pivotal changes to Medicare. “
Recommendations
The AMA believes that pausing Stage 3 at this time will provide the opportunity to evaluate the environment and work with the administration to implement the needed changes to the Meaningful Use program that are currently under consideration. The pause is not expected to delay progress with EHRs, rather move the MU program forward to effectively drive innovation and adoption. The coalition of physician organizations recommends that administration proceed with finalizing the Modifications Rule as well as with integral pieces of the proposed 2015 Edition Certification Rule as soon as possible.
Additionally, the AMA recommends the administration establish an additional hardship exemption category for physicians who could not anticipate new program mandates so late into the year.
“There is growing bipartisan recognition in Congress that the direction of the Meaningful Use program needs to be reassessed in light of usability and interoperability challenges with electronic health record systems,” said AMA President Steven J. Stack, M.D. “Poorly performing systems that do not facilitate the seamless exchange of data would severely undermine the ability of the health system to support the implementation of the payment reforms outlined in MACRA.”
To date, 80 percent of physicians are utilizing EHRs, but less than 10 percent of physicians have successfully participated in MU Stage 2.
