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    The uncertain future of Meaningful Use


    MIPS is a pay-for-performance program that is one of two tracks that physicians can choose for Medicare reimbursement under MACRA. (The other consists of “alternative payment models” [APMs] such as accountable care organizations and patient-centered medical homes.)
    If physicians select MIPS, they will be measured on their quality, efficiency, practice improvement activities, and meaningful use of EHRs. The resulting scores will increase or decrease their Medicare income 4% in 2019, rising to 9% in 2022.


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    Because CMS usually has a two-year interval between performance and payment adjustment in its programs, some observers believe that CMS plans to introduce a new and improved Meaningful Use program next year as part of MIPS. If so, how physicians perform not only on Meaningful Use but also on the other three components of MIPS will determine how much they are reimbursed by Medicare in 2019.
    The week after Slavitt’s speech, he and Karen DeSalvo, MD, MPH, the national coordinator for health IT, published a blog post clarifying some of Slavitt’s remarks. Among other things, they made it clear that the incentives and penalties under Meaningful Use will continue.


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    That means physicians who did not attest to Meaningful Use for 2015 (and did not qualify for an exemption) will still be penalized in 2017, and those who fail to show Meaningful Use this year will receive payment adjustments in 2018. These payment incentives can be adjusted under MACRA but will continue, Slavitt and DeSalvo said.
    The penalties for not demonstrating Meaningful Use are required through 2024, notes Naomi Levinthal, MA, a senior consultant with the Advisory Board Co., a Washington, D.C.-based healthcare consulting firm.
    The CMS blog post also pointed out that, until the upcoming MACRA regulations are finalized, the current Meaningful Use rules will remain in force, including those for stage 3.

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