Commentary: It’s funny how things change in a short amount of time. Despite widespread calls from industry groups and Congress for a delay, the Centers for Medicare and Medicaid Services in October stubbornly issued its final rule for Stage 3 of the Meaningful Use program, which is set to begin in 2018.

Fast forward just three months and CMS is now telling us that MU will end sometime in 2016.

In a speech earlier this week that has attracted much attention, CMS Acting Administrator Andy Slavitt told an audience at J.P. Morgan’s annual healthcare conference that the Meaningful Use program “as it has existed, will now be effectively over and replaced with something better.”

Slavitt’s remarks were heavy on shock value—no one anticipated this radical policy shift, even in the face of growing stakeholder concern that the Meaningful Use program is broken. But, at the same time, he provided no details, promising that specifics would be released over the next few months on where the industry goes from here.

“Now that we effectively have technology into virtually every place care is provided, 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 CMS chief declared.

Slavitt had barely finished his speech—the full transcript of his talk was posted online in a blog—when CMS spin doctors jumped into action, trying to explain the agency’s dramatic new direction.

In response to a query from Health Data Management, Aaron Albright, director of CMS’s media relations group, contended that Slavitt’s comments were “consistent with what we have already announced in the final rule in October.”

Albright pulled a quote from that final rule stating that CMS would be using industry “feedback to inform future policy developments for the EHR Incentive Programs, as well as consider it during rulemaking to implement MACRA, which we expect to release in the spring of 2016 and other rulemaking as appropriate.” The agency spokesman also noted that the final rule states that it “moves us beyond the staged approach of ‘meaningful use’ by 2018 and helps us collectively move forward to a system based on the quality of care delivered, as opposed to quantity.”

However, it’s one thing for CMS to state in its rule that Stage 3 is intended to be the final stage of the Meaningful Use program, and quite another to announce that MU will be going away altogether—and soon. Under the final rule, providers in the Meaningful Use program were given the option of voluntarily participating in Stage 3 in 2017, with participation becoming mandatory in 2018.

When asked whether the end of Meaningful Use in 2016 would effectively mean that Stage 3 will not be implemented, Albright wrote in reply: “I don’t have anything beyond what we have previously announced.”

Clearly, CMS has a lot to work out. What is undeniable, though, is that the Stage 3 rule was finalized without consideration of the changes to Medicare mandated by MACRA. Now, the agency is trying to reconcile the two, with the Meaningful Use program not so gracefully bowing out.

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