Why the MU extension is failing physicians

Keith BlankenshipKeith Blankenship

The industry seemed to sigh in relief when the Centers for Medicare & Medicaid Services (CMS), alongside the Office of the National Coordinator for Health IT (ONC), extended meaningful use Stages 2 and 3 earlier this month. But aside from a bit of breathing room, some experts are saying that the move doesn’t really offer much else.

“The extension in my opinion will not greatly impact adoption trends,” Keith Blankenship (pictured), vice president of technical solutions for Lumeris, an accountable care delivery innovation company, told Medical Practice Insider.

According to Blankenship, the extension was not designed with provider adoption in mind. It was put in place to allow CMS and ONC to hone their efforts to enhance patient engagement, interoperability and health information exchange in Stage 2. All of the 2014 deadlines for meaningful use, in fact, must still be met.

“In reality, the extension and flexibility really only applies to the transition to Stage 3 meaningful use,” he said, “and perhaps some back-end Stage 2 software deployment.”

Valuable changes will not be made by trudging forward on thinning ice, Blankenship argued, but by magnifying EMR necessity and how physicians will be paid. “In order to really impact adoption trends, we need to take a step back and focus on the extension of Year 1 meaningful use, and then help physicians see the long-term return on investment for EMR adoption by changing current reimbursement models,” he added.

The average loss for a practice five years after EMR adoption is $44,000, according to a Health Affairs study. This needn’t be the case, however, if the right incentives are put into play — on the proper playing field.

“In a value-based model, physicians are paid for outcomes. Technologies that integrate data and provide a more complete view of a patient’s medical history enable positive outcomes. With these technologies, physicians can close gaps in care, coordinate care throughout the continuum, note medication adherence and truly manage populations,” Blankenship explained. “However, physicians are not incentivized to achieve positive outcomes; [instead] they are incentivized to see as many patients as possible in a small amount of time.”

While CMS data shows that EMR adoption rates have nearly doubled among physicians in the past three years, meaningful use of EMR systems is still painfully low. Blankenship finds that only 12 percent of physicians have attained meaningful use, a statistic that will persist if “physicians are not paid for outcomes or value, but for the volume of patients they see.”

Thus, it’s time for regulators to get their priorities — and incentives — straight, an alignment that physicians themselves can hasten by simply being aware of their adoption reality and speaking up about it, he commented.

“Physicians are realizing that the investment in technology in fee-for-service medicine will produce no long-term return on investment,” Blankenship concluded. “Meaningful use has helped draw attention to much-needed technological advancements, but the only way we will successfully move forward to Stage 2 is to incentivize physicians to deliver positive health outcomes for patients and populations.”