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Meaningful use will still be part of MIPS reimbursement, CMS official says

Value-based program will score physicians on quality, resource use, practice improvement and certified technology.
By Mike Miliard
04:34 PM
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LAS VEGAS – Officials from the Centers for Medicare and Medicaid Services on Wednesday said physicians should expect meaningful use of electronic health records to still be required under coming changes to how CMS pays them under MACRA.

The announcement came during a HIMSS16 listening session focused on the new Merit-Based Incentive Payment System.

Kate Goodrich, MD, director of CMS' Center for Clinical Standards and Quality, said that CMS hopes to release the rules in the next few months after collecting feedback from physicians across the country.

[Also: Slavitt, DeSalvo: Health IT has to work better for doctors]

"Our intent is to have a single, unified program," she said, while at the same time offering flexibility and avoiding a one-size-fits-all approach. "We know physician practices are very different from one another.”

Goodrich couldn’t share details since CMS is still in the rulemaking stage, but she did offer a broad overview.

The new rule will reimburse physicians based on four factors, grading them with a composite performance score factoring in their quality measures (30 percent), resource use (30 percent), clinical practice improvement activities (15 percent) and meaningful use (25 percent).

Toward its goal of consolidating CMS reporting rules while expanding the number of providers participating in value-based initiatives, the Medicare Access and CHIP Reauthorization Act paves the way for eligible professionals to take part in quality programs through either MIPS or other alternative payment models such as accountable care organizations, patient-centered medical homes or bundled payments.

MIPS and APM incentive payments are set to begin Jan. 1, 2019. 

Separate payment adjustments under the Physician Quality Reporting System, Value-Based Payment Modifier and the meaningful use program will sunset Dec. 31, 2018, according to CMS.

[Also: See photos from Day 2 of HIMSS16]

Meaningful use will still be a core component of the program, said Molly Macharris, MIPS program lead at CMS. At the event, she sought feedback on whether the performance score for technology should be based solely on full achievement of meaningful use, or whether CMS should use a tiered methodology for determining levels of achievement.

Other questions included what alternate methodologies the agency should consider for the technology performance category, and how should hardship exemptions be treated.

The emerging MIPS framework is "our vision for a future state," said Godrich. 

"It will take time to get there," said Goodrich. "And we'll only be successful if we listen carefully."

Twitter: @MikeMiliardHITN


This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.