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MACRA Implementation

According to the Merit-based Incentive Payment System (MIPS), policymakers must review the earlier transition from Meaningful Use Stage 1 to Stage 2, while transitioning from MU Stage 2 to Advancing Care Information. This is to ensure consistent clinical quality of healthcare during the transition.

The Journal of the American Medical Informatics Association published a recent study, which revealed a consistency in clinical quality when health care organizations were progressing through the first two stages of Meaningful Use.

“To progress from MU1 to MU2, eligible providers were required to meet higher thresholds on provider-selected objectives similar to MU1, provide portal access to patients, communicate with at least 1 patient using secure EHR-based messaging, and perform more complex health information exchange. The incremental benefit of transitioning from MU1 to MU2 on quality is unknown,” the research team stated.

The study was conducted in two different timeframes, October and December 2014, and September and November 2012, in hospitals that are affiliated with Brigham and Women’s Hospital. The system had attested to both stages of Meaningful Use during these above stated periods.

Researchers analyzed the clinical quality measures such as influenza immunization, hypertension control, diabetes control, Chlamydia screening, tobacco use assessment and counseling, and senior weight screening follow-up, during these periods. The study highlighted that these clinical quality measures remained consistent in between both the phases of the program.

The researchers witnessed an improvement of 35 to 40 percent in hypertension control, 63 to 68 percent in influenza immunization, 86 to 96 percent in tobacco use assessment and counseling, and 93 to 96 percent in diabetes control in the MU Stage 1 to Stage 2 transition period. However, researchers also noted a decline in senior weight screening during the same period, which went down from 54 percent in Stage 1 to 49 percent during Stage 2.

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Merit-based Incentive Payment System

“While our study does not create a causal link between the transition to MU2 and quality, it suggests that some of the elements, such as electronic reporting of clinical quality measures at stricter thresholds, secure messaging, and information exchange, may have a positive effect on quality,” researchers said.

They further added that these findings might have implications for the transition to MIPS and Advancing Care Information, and confirmed that even though the Advancing Care Information performance category has numerous differences from Meaningful Use, it would still have a few same elements.

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