Internists Suggest Ways to Make 'Meaningful Use' More Effective and Acceptable to Physicians and Their Patients

Comments Sent to CMS by ACP Urge Requirements be Retooled to Truly Boost Quality

(Washington, December 17, 2015)- The American College of Physicians (ACP) this week urged the Centers for Medicare and Medicaid Services (CMS) to eliminate the current meaningful use requirements. ACP filed extensive comments on the meaningful use makeover in a 12-page letter to CMS from Dr. Peter Basch, chair of ACP's Medical Informatics Committee.

CMS should be receptive, said Dr. Basch. "They're looking for new thinking and this is the time to get this settled." Meaningful use is getting another look now because CMS has taken an unusual step. The agency has asked for a second round of comments regarding Stage 3 of the meaningful use requirements. That's because the previous round of comments became outdated once the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted. Under the new system, physicians who take Medicare must make choices about how they'll be paid starting in 2019. ACP fears that physicians will leave Medicare if they provide quality care but fail to meet arbitrary meaningful use requirements by, for instance, e-prescribing 59.9 percent of the time instead of 60 percent. But simply getting rid of meaningful use entirely isn't feasible unless Congress changes the law.

Moving ahead, Basch said, electronic record requirements should boost quality and value in medicine -- but only in unique ways that aren't accomplished by other incentives. "They need to be retooled to support physicians and help them achieve good performance on value and quality measures," he said.

A proposed rule for MACRA should be released by next spring, providing some level of detail about the various components, Wayne J. Riley, MD, MPH, MBA, MACP, president of ACP, said. Then there will be another comment period before a final rule is released, possibly in late 2016.

The new system won't affect doctor reimbursement levels until 2019, but doctors are likely to start being measured under the new criteria as early as 2017, he said. Those measurements will affect their reimbursements in 2019.

"ACP's members are very frustrated and dissatisfied with the current meaningful use program," Dr. Riley noted in conclusion. "Even those who can meet the requirements feel that it is a distraction and inconvenience from taking care of our patients. We look forward to working collaboratively with CMS to address its shortcomings."

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 143,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

David Kinsman, (202) 261-4554,