While Meaningful Use has been challenging at times, the vast majority of hospitals seem to have stayed on top of things. In its new report on the IPPS negative payment adjustments for fiscal 2017, CMS said that 98% of eligible hospitals and critical access hospitals managed to avoid Medicare payment dialbacks for next year, because they successfully attested to stage 1 or stage 2 Meaningful Use compliance, according to EHR Intelligence.
CMS began making Medicare payment adjustments on October 1, 2014 for eligible hospitals, of which there are more than 4,800 in the United States. The current adjustment will fall into place on October 1, 2016, as a reduction in the percentage increase to the Inpatient Perspective Payment System.
The negative payment adjustments to the IPPS now stand at 75%, up from 25% for the 2013 reporting period. Eligible hospitals had a chance to apply for hardship exceptions to the payment adjustments, though if they haven’t done so already it’s too late, as the window for seeking those exceptions for 2017 closed in April of this year. But as noted, few hospitals will be affected.
At this point, it’s worth taking time to stop and admire how this took place. Even when you consider that the feds handed lot a lot of money in incentives, this has all happened relatively quickly as IT investments go. Everyone likes to talk about how successful the banking industry was at rolling out interoperability with ATMs, but I doubt the backroom negotiations went any faster than the cascade of Meaningful Use attestations. In other words, Meaningful Use did its job.
After all, very few programs achieve close to 100% compliance under any circumstances. Even if providers face large government fines, no initiative is going to get 100% of the industry on board. So bringing 98% of eligible hospitals on board within a few scant years is an impressive achievement, particularly considering the healthcare industry’s record of foot dragging when it comes to new technologies.
Of course, the industry has clearly gone well beyond the need for Meaningful Use’s rather mechanical reporting requirements, valuable though they may have been as a training ground. So if we assume that Meaningful Use isn’t that, well, meaningful anymore, what’s next?
The answer is….drumroll…quality. Most hospitals will be focusing on the larger and more complex quality measurement demands imposed by the next generation of incentive payments proposed by CMS.
As many readers know, the Medicare Meaningful Use program for ambulatory is being rolled into the Merit-Based Incentive Payment System (MIPS), along with the Physician Quality Reporting System and Value-Based Modifier programs. beginning with the 2017 performance year.
Meaningful Use now has a new name in ambulatory care, Advancing Care Information, and strong performance on this measure can contribute up to 25% of the MIPS score a provider receives – or in other words, smart health IT deployment still counts. But that’s dwarfed by the 50% of the score contributed by strong quality performance.
This shift away from IT-specific performance measures is necessary and valuable. But as federal authorities lay out their new incentive programs, it’s worth giving good ol’ Meaningful Use a send-off. A job needed to be done, and however unsubtly, MU did it. We’ll see how quickly the MIPS program rolls over to replace MU in hospitals.