CMS Promises Meaningful Use Replacement by end of 2016

In one sense, talk of the program's transformation comes as no surprise, given the passage last year of the (MACRA), which repealed the sustainable growth rate formula for physician pay. MACRA shifts Medicare compensation from fee-for-service to pay-for-performance (PFP), also known as pay-for-value.

Under MACRA, physicians choose between two PFP models:

1. The alternative payment model (APM), which is more advanced, is for physicians participating in patient-centered medical homes, accountable care organizations, and Medicare shared-savings programs.
2. The less advanced model is the Merit-Based Incentive Payment System (MIPS). It will incorporate and align EHR meaningful use and two other incentive programs — the Physician Quality Reporting System and the Value-Based Payment Modifier. Medicare will increase or decrease a physician's fee-for-service reimbursement in MIPS according to his or her quality of care, use of medical resources, clinical practice improvement, and meaningful use of EHRs.

Physicians will begin to get paid through MIPS and APMs in 2019.

How the two new payment models under MACRA will operate exactly — and what will become of meaningful use — is still a matter for CMS to decide. The agency expects to issue proposed regulations fleshing out MIPS and APMs sometime this spring and, after mulling over public comments, release a final version later in the year.

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