The Death Of Meaningful Use
By Linda M. Girgis, MD, FAAFP
Earlier this month, CMS acting director Andy Slavitt announced the Meaningful Use (MU) program will effectively cease to exist as we know it. Almost immediately, stories popped up proclaiming MU was dead and gone, but the authors of those stories failed to hear what Slavitt was actually saying – MU is being replaced with something better.
Even if they missed that part of Slavitt’s message, they should have remembered legislation was passed last year laying out exactly what was going to happen. So, while many rejoice at the demise of MU, its successor — a merit-based incentive payment system (MIPS) — is being planned.
MU did not die because something better was developed: it died because it was impossible to work from the onset. Who killed it? CMS hinted they heard doctors’ voices but, in reality, they did not.
Rather, CMS realized MU was not only unsustainable but failed at the basic goal it was designed to achieve: interoperability. While the technology could possibly be developed to build bridges between all systems, EHR vendors were not willing to undertake this task. They killed it because they did not want to work together. There was too much competition and too much money grabbing and vendors were not willing to share the technology and know- how needed to achieve interoperability.
While MU was failing to meet its main objectives, doctors and other healthcare providers were still mandated to implement EHR technology and comply with requirements or be hit with financial penalties. How can mandating healthcare to use technology that does do want it is supposed be explained? After pouring millions of dollars into the fatally flawed MU program, it can’t. But, the government will never admit this.
What happened to MU? It became re-invented and swept up into the MIPS program. And everyone was informed of this last year when the MACRA bill was passed, buried in the minutiae and legal language of this enormous legislative bill. Many missed it at the time, but this bill made it clear MU was going away and its component be rolled out in MIPS format.
Compliance was always optional with MU program. Of course we faced financial penalties if we didn’t comply but, for many of us, the requirements were not worth it. I completed MU Stages 1 and 2 but it was a great undertaking that I do not believe benefitted my patients or me.
Now, under MIPS, we no longer have a choice. We have to comply if we want to be paid. I’ve seen estimates that 25 percent of the MIPS program will be based on MU metrics reporting. We will be required to report clinical metrics based on previous PQRS reporting requirements along with technology requirements that were developed under MU. The disruption to our practices will be nothing like that under the MU program, it will be far worse. Those who tout MIPS claim it improves clinical outcomes. Data is very important in medicine these days but not when it steps between the doctor and patient.
MU is not dead as many now claim. It is still very much alive and developing a life of his own. EHR and technology are great tools in medicine, and data tracking can be beneficial as well. But, improper use is deadly. Do we want to keep patients healthy? Or is the well-being of political agendas our new aim in healthcare?
About The Author
Linda Girgis, MD, FAAFP, is a board certified family doctor with Girgis Family Practice. Dr. Girgis studied medicine at St. George’s University School of Medicine and served her residency at Sacred Heart Hospital in Allentown, PA.