Oh, Meaningful Use (MU), you’ve run your course. That was fast. According to the Journal of the American Health Information Management Association (AHIMA), last October, CMS announced the third stage of the Meaningful Use guidelines. But only three months later, CMS’s acting administrator, Andy Slavitt, announced the end of the program as we know it: “The Meaningful Use program as it has existed will now be effectively over and replaced with something better,” he said to a crowd of attendees at the JP Morgan Annual Health Care Conference.
According to Anil Jain, MD, FACP, and Karen Handmaker, MPP—the authors of this Becker’s Healthcare article—“this statement could appear to answer the prayers of clinicians across the country who have railed against the onerous requirements of Meaningful Use since its inception.” However, much of MU will still live on—and it’ll impact physical therapists and the future of physical therapy technology. Here’s how:
Rehab therapists are now eligible professionals.
Instead of being a standalone program, MU will be consolidated—along with the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (VM) program—into the Merit-based Incentive Payment System (MIPS), which will officially go into effect in 2019 (based on reporting starting in 2017). While therapists weren’t considered “eligible professionals” under MU, they will be under MIPS—and its umbrella program, the Medicare Access and CHIP Reauthorization ACT (MACRA). According to Slavitt, "At its most basic level, [MACRA] is a program that brings pay for value into the mainstream through something called the Merit-based Incentive Program, which compels us to measure [providers] on four categories: quality, cost, the use of technology, and practice improvement.”
Reporting won’t actually begin until 2019 for rehab therapists.
As WebPT’s Brooke Andrus explains in this Quick Guide to the 2016 Final Rule, “rehab therapists aren’t eligible to participate in MIPS in either 2017 or 2018; thus, they will not be subject to any associated penalties or incentives.” While many of you may be thinking that two years off from quality reporting is a good thing, Andrus explains—in this post—that this delay could result in some potential problems, including the fact that a “lack of available data for rehab therapists could unfairly skew the perceived value of rehab therapy.”
Regardless of whether you’re in favor of the two-year hiatus, it appears that PTs will have some extra time to think through the impact that these changes will have on their practices—including their technology—and adapt accordingly. If used wisely, this extra time could be just what the industry needs to come out swinging in 2019.
Technology must serve a new end: outcomes tracking.
Whereas MU required all eligible professionals to use an EHR that was Meaningful-Use certified, MIPS is taking the focus off of the technology itself and placing it on the outcomes clinicians are able to achieve through the use of technology. According to Jain and Handmaker, “Through MACRA, CMS appears to be placing more emphasis on delivering better outcomes rather than on driving technology adoption, aligning to those stakeholders who have long embraced the move from traditional fee-for-service to value-based care initiatives.” So, while physical therapists still don’t need an EHR certified for MU, they absolutely must implement a software system that enables them to measure meaningful outcomes—and use the data they collect to communicate the effects of their therapeutic interventions. Furthermore, based on Slavitt’s comments in the above-cited Journal of AHIMA article, CMS wants providers to be able to customize “their goals so tech companies can build around the individual practice needs, not the needs of the government.” (Specialized software, anyone?)
The goal is to demonstrate a truly meaningful use of technology.
According to Jan and Handmaker, providers “who excel at driving high quality outcomes and reducing unnecessary cost by integrating complex data, providing advanced analytics, and generating actionable insights will be in a position to achieve success in our evolving environment.” Furthermore, “Powerful partnerships will enable engagement between patients and providers, while helping to foster both patient and provider satisfaction. And that will demonstrate truly meaningful use of technology.” We couldn’t have said it any better ourselves.
Value-based payment systems are here to stay.
Think value-based payment systems might also go the way of Meaningful Use? Think again. According to Jain and Handmaker, “Another point that came through loud and clear in Mr. Slavitt's remarks was this: value-based care is here to stay.” Apparently, Slavitt spoke strongly about CMS’s plans to further transition “financial risk” to organizations that demonstrate the ability to “use traditional care models, telemedicine, home visits, and direct consumer incentive and engagement options to reduce cost while promoting outcomes.” (Called it.)
What do you think the end of Meaningful Use means for the future of PT technology? What do you believe constitutes a “truly meaningful use” of technology? Tell us your thoughts in the comment section below. We’d love to hear ’em.