Meaningful Use Program Officially Shelved?
For those who don’t know, meaningful use is another bogus metric that the government was using to initially bonus doctors (and then penalize them). You had to go through a million expensive hoops to prove your EMR/EHR worked well enough for the government’s bogus standards. Well, now the chief of the CMS, Andy Slavitt, announced that:
“We are now in the process of ending meaningful use….”
The AAFP is getting all cocky because they showed their might in getting this done. “You like that?!?” they scream to their members. But was it them that got this to change? Back in May they just wanted the Meaningful Use to be “reasonable”.
That’s like some nerd kid getting beat up at the playground asking the bully if he can be reasonable. And then gets punched 500 times in the face.
Oh, and let’s not forget what the AAFP said in 2010 as shown here in a Medical Economics article:
The president-elect of the American Academy of Family Physicians said he was cautiously optimistic about the final rules for the “meaningful use” of an electronic health record (EHR).
In July, Roland Goertz, MD, testified before the U.S. House Energy and Commerce Subcommittee on Health regarding the Health Information Technology for Economic and Clinical Health (HITECH) Act. In part, the act awards physicians up to $44,000 over five years if they prove “meaningful use” of EHRs. The incentive’s rules were finalized in July.
“We believe the recently issued rules will be achievable, but they do require significant effort by physicians and their practices,” Goertz said. “We ask your committee to help make sure that [the Centers for Medicare and Medicaid Services] delivers on the execution of this program,” he told the committee. “If the first rounds of reporting and incentives do not go smoothly, many physicians will turn away from this program.”
Cautiously optimistic. Achievable. Yup. Now commence punching.
So now back to Slavitt and the CMS. What else did he say?
“We are now in the process of ending meaningful use and moving to a new regime culminating with the MACRA (Medicare Access and CHIP Reauthorization Act) implementation. The meaningful use program, as it has existed, will now be effectively over and replaced with something better.”
Replaced by something better? Well, I for one am optimistic. I am optimistic that family docs will get punched again in the face about 500 times.
Every physician who has ever vocally or politically supported the Medicare program, or the fiction of keeping it “sustainable” is guilty in this farce. If you think a patient has a right to government-funded health care just because he is old, then this is the result. It’s not just that the program as a whole is done badly, but that it exists at all. All of these stupid programs and failed funding gymnastics occur because greedy voters empowered the government to do something for which it was not designed. The cowardly GOP candidates would not touch this in their latest debate, and the insane Democrats will never admit it. Medicare is a bad idea and a lousy program. Tye AARP lobby will literally destroy Thi economy before allowing serious reform.
“We are now in the process of ending meaningful use….” How should we understand this?
-We should think about it the same way that the totalitarian dictatorships “undergo meaningful change.” They create a Department of X to enforce some cruelty, promote a sadist Mr. Y to run it, and let it roll along for a few years, beating, torturing and intimidating the populace.
-Then they discover the “excesses” of Mr. Y, and throw him in prison. The Department of X is immediately “Refomed” – i.e. given a new name – and Mr. Y is replaced by his cunning and amoral second-in-command. Off to the firing squad with YOU, Mr. Y, you evil guy!
-The same principle is going on here. “Meaningful Use” is a bad buzzword for too many people. It has become known outside the medical community that it is an awful mess. So reform it, right?
-End-User-Friendly Data-Driven Information Exchange Skills. Let’s call it that, although it doesn’t make for a clever acronym. Throw a few senior bureaucrats under the bus in the CMS and EHR programs.
-After all, this is the product of thirty BILLION dollars worth of IT work. It was a Federal undertaking on the scale of the Marshall Plan if not the Manhattan Project. And it has produced something that doesn’t work. A few scapegoats have to be terminated for this size fiasco – and CMS and HHS are Federal Bureaucracies, there are plenty of vicious backbiters who will deliver up their frienemies for elimination.
-It will become “user-driven,” “data-friendly,” and all sorts of other buzzwords will encrust the new entity that is not at all new. Doctors will complain that it is a Trojan Horse, the same old MU3 crap as before. Spokesmen will sigh in public, and say – “What do these rich doctors want? We’ve given them everything they’ve asked for, we’ve bent over backwards to make this user-friendly and data-driven, and they don’t care!!”
That’s how government works, whether “win(ning) the hearts and minds of the Iraqi people by bombing the H___ out of them.” or other projects. When the starting premise is “We will do exactly what we want, when we want, and the way we want to. Anything else is open for discussion,” what then?
(PS for Fred. The world USED to run on DPC. Primary care doctors FOUND pathology, specialists TREATED pathology in their specialty. It DOES work. What goes on in the rest of the world with a bad appendix? Someone without good training, without a laparoscope, and far worse surgical supplies, fixes it for money. Are we the only place on the globe with appendicitis and chole’s? Caesarians?)
The MU program has wasted millions of dollars and hours and caused significant impairments to the physician-patient relationship. Many docs on the front lines could have and probably did tell CMS this was a waste.
Now they are coming up with even more convoluted confusing schemes to “pay” doctors which will cost even more millions and drive even more docs out of practice. Slavitz says he wants to “win the hearts and minds of doctors”. This is like saying we’re going to win the hearts and minds of the Iraqi people by bombing the H___ out of them.
Thanks, CMS!
It’s very good news that CMS is shelving Meaningless Use although I can’t imagine AAFP had anything to do with it. Now we get to hold our breaths and hope whatever it’s replaced with won’t be even worse. My jaded opinion is it will be just as bad, since the same flaw still exists – the government believes it can accurately measure and improve quality while having little understanding of processes and reasoning at the doctor-patient level.
Don’t be lulled into thinking any of these programs that are engineered to pay physicians less are sunsetting anytime soon. The “newer, better” version is only “better” for the entity that has over 200 trillion in unfunded future liabilities. The new version will f*ck physicians out of about 10% of their fees. If specialists could go the direct care route , I would be there.
C’mon.
“In 2009 the United States Congress passed “The HITECH Act”, which is part of the economic stimulus package American Recovery and Reinvestment Act of 2009 (ARRA). The ARRA stimulus plan was initiated by President Obama, and designed to stimulate the economy and increase consumer spending during the recent recession.
As part of the $787 billion stimulus package, $32 billion was allocated to upgrading the infrastructure of the healthcare and medical industries. $10 billion is to be used for the construction of National Institutes of Health facilities for health research(!!!). And $22 billion is to be used for upgrading health care IT systems, namely to assist in the upgrading of personal medical information to a standardized “electronic medical records” system, also referred to as EMR or electronic health records (EHR).”
http://www.electronicmedicalrecords.com/stimulus/
C’mon now, you guys – “Wasting MILLIONS?” MILLIONS? That’s so nineteen-twenties, Calvin Coolidge-ey. Are you doing the Charleston or the Lindy Hop?