Meaningful Use. Still Here.
In the wake of the J.P. Morgan conference and CMS' pro tem administrator Andy Slavitt's bombshell announcement that "In 2016, MU as it has existed - with MACRA - will now be effectively over and replaced with something better", speculation has been rife. But nothing has reached my ears concerning the specifics. In fact, the CMS web site has been conspicuously silent on the subject.
Such an impactful change should not be like a magician pulling a dollar out of your ear. I for one don't want to experience the surprise of being presented with such sleight of hand. I personally would prefer to know what, where, when and how. The mechanics. Does anyone out there have anything concrete to offer on this subject, beyond guesswork? I find the silence deafening.
A CMCS informational bulletin on the Medicaid.gov web site dated Jan 8, a week before the announcement, carries the academic sounding title of "Options for Medicaid Payments in the Implementation of the Fair Labor Standards Act Regulation Changes". It is at the time of writing the most recent document on their home page. The CMS itself has on their web site no mention of any sweeping changes. In fact, as I type, the Spotlight section on the CMS home page has a link titled "Learn about the MACRA and how we’re paying for value and better care" which takes you to a very detailed page full of resources which go into great detail about MACRA and other services. MACRA, short for the Medicare Access and CHIP Reauthorization Act of 2015, was only passed in the senate last year. Most agree that the main benefit of the MACRA legislation was the elimination of the universally loathed Sustainable Growth Rate (SGR). That, at least, is unlikely to change. But beyond that... what is actually going on?
Will MACRA and Medicaid somehow be separated? Is the new born MACRA being shelved? Rewritten? Will Medicaid be integrated into some other payment incentive scheme, be unceremoniously dumped, or developed into some kind of independent framework that no longer needs support from other programs? We don't know. Nobody knows. Those within the CMS that may have some idea on the matter are keeping remarkably quiet. Disregarding the rhetoric and media hype, few hard facts have been made available. We will just have to wait and see what comes next. And that makes it very hard to plan for the future.
Best idea at this stage, then? Business as usual. Until such time as an announcement is made to the contrary, Meaningful Use still stands as legislation and as such should be followed, if you want to avoid the risk of penalties and maximise incentive payments.
Slavitt said 2016. There are eleven months of 2016 remaining, and that takes us through the election, which introduces a whole new batch of decision makers wanting to make their marks, or change their predecessors choices, or filibuster and delay. This could take a while. In a nutshell, then, MU is unlikely to just go away overnight, and therefore legal compliance remains a requirement. Until, at least, we hear something solid that says otherwise. Whatever comes next, I’m going to keep checking my ears for dollar coins. We have an interesting year ahead.