Why are Docs Opting Out of Meaningful Use?
The Meaningful Use program – designed by the Centers for Medicare and Medicaid Services (CMS) to speed up adoption of electronic health records (EHRs) – is not everyone’s favorite initiative. But just how unpopular the program is across the healthcare industry may surprise you.
According to a 2014 report from Medscape, 22 percent of physicians are opting out of Meaningful Use. (16% of those surveyed said they will never attest to the CMS’ requirements, and another 6% of participants said they abandoned the program after meeting the requirements in previous years.) A survey from SERMO predicts that over 50 percent of physicians will not attest to the requirements in 2015.
So what’s motivating docs to drop out?
The Lack of Financial Benefit: The penalties for failing to meet Stage 2 of Meaningful Use are minimal and the majority of incentive payment money in the program was linked to Stage 1. There’s simply not much financial upside to participating beyond the first phase.
The Burden of Expectations: Meaningful Use Stage 2 requires far more effort on the part of physicians and practice managers than Stage 1. 2014 likely saw such a high number of drop-offs because providers saw the CMS’ quality measures and attestation expectations to be too high.
The Patient Involvement Factor: Stage 2 also requires practices to expand their use of patient portals linked to EHRs: It’s required for 5 percent of an organization’s patients to “view, download or transmit to a third party” their health information using online tools. If a practice serves an elderly or low-income population, that can be difficult to achieve due to patients’ lack of comfort with or access to technology.
The Minimal Clinical Impact: Are the patient benefits to be achieved from EHR implementation commensurate with the effort, expense, training, and time required to comply with the CMS’ program? Will Meaningful Use of an EHR result in better clinical outcomes? Many don’t think so.
The Other Issues at Hand: The mandated shift to the ICD-10 code set is coming quickly (October 2015). Practices have their hands plenty full preparing for that burdensome transition, as well as complying with the Affordable Care and recent amendments to HIPAA. All of those factors are motivating medical practices to put Meaningful Use on the back burner.
The Fact that Almost Doesn’t Count: CMS refuses to provide partial reimbursement to any practice that tries and fails to meet Meaningful Use requirements. That means if after months of hard work your practice comes close to meeting the Stage 2 goals but comes up short, you’re still on the hook to pay the penalties. To some, recognizing that they’ll be penalized up front feels less risky than the prospect of failure.
Opting out of Meaningful Use is an option for every practice, but it’s not a decision to be made lightly. For some, having an EHR seems pointless if it fails to earn them the reward of incentives. To others, using an EHR results in enough financial benefit (via increased revenue and productivity) that the incentives feel unnecessary. Still others won’t give up paper records no matter how much they’ll be penalized. Figure out how you feel about Meaningful Use and make a thoughtful choice for your business’ bottom line.
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