Meaningful use: Pros and cons of attesting

According to the AUA, CMS began applying penalties in 2015 for the 2013 reporting period for providers who did not attest or failed to achieve meaningful use. While the law allows for a hardship exemption for the 2015 reporting period/2017 adjustment year, it offers no protection for 2016/2018.

“The Stage 2 modifications for 2015 through 2017 make several changes to the program objectives and associated measure thresholds to make it easier to achieve meaningful use, including use of a specialized registry,” the AUA wrote in a statement to Urology Times. “The AUA believes that participating in its AUA Quality Registry (AQUA) will allow eligible professionals to meet the measure under the public health objective of Stage 2 pertaining to the successful transmission of data to a ‘specialized registry,’ provided that the data is being transmitted directly from a certified EHR to the AQUA Registry.”

Physicians are required to attest to modified Stage 2 meaningful use for the 2015 reporting period, with some exceptions, including Medicaid and first-time participants. CMS’s intention with the modifications is to prepare physicians for transition to Stage 3; however, physicians are likely to encounter many of the same obstacles-tremendous start-up and maintenance costs, lack of interoperability, and the all-or-nothing attestation requirement. The required year-long reporting period for 2016 and 2017 may also pose a challenge for some physicians, according to the AUA.

Next: "The financial incentives may help offset some practice expense and administrative costs.”

“In 2018, EHR penalties are scheduled to sunset; however, the same meaningful use objectives and associated measures will transition to MIPS weighted at 25% of the performance composite score,” according to the AUA response. “The upside of MIPS is that providers can receive a positive, negative, or neutral payment adjustment at a maximum of 4% to 9% over a period of years. The financial incentives may help offset some practice expense and administrative costs.”

Also see - AUA meaningful use recommendations: 6 steps moving forward

Under MIPS, the law allows the Secretary of Health and Human Services to decrease or shift the EHR weight (up to 15%) to other categories if the proportion of physicians demonstrating meaningful use is 75% or greater. This is encouraging but unlikely given the high percentage threshold and the growing decline in meaningful use provider attestation.

Eligible providers (EPs) who qualify to participate in alternative payment models (APMs) will be excluded from MIPS and receive a 5% lump-sum incentive payment for that year. However, EPs will still be required to use Certified EHR Technology (CEHRT) for eligible APMs, so EHR reporting is not going away. Starting in 2026, EPs in MIPS will receive a lower conversion factor (0.25%), versus a 0.75% conversion factor for EPs who qualify for eligible APMs. Only a small number of providers are expected to be early adopters of APMs, according to the AUA.