Meaningful Use Changes You Should Know, 2019 Updates Included

June 11th, 2019

Updated: June 11, 2019

Keeping up with new legislation can be a challenge. The most worrisome to practices are changes Meaningful Use attestation. The program has evolved over the years into a more manageable list of requirements meet and depending on practices participation, add monetary incentives. Providers have trouble staying up-to-date with the ever-changing program, so we wanted to easily outline the changes for reporting in 2018 that you need to know. We have also added the updates for 2019.

2017 was the first reporting year for practices participating in MACRA, and they will see incentives/penalties in 2019. As you report for 2018, you will see the effects in 2020. Great news, the adjustment to reporting requirements in 2018 are similar to 2017.

2015 Edition CEHRT Bonus 

The CMS is rewarding Eligible Clinicians (EC) that are utilizing a 2015 Edition CEHRT up to 10% when reporting in 2018. RxNT is one of few EHR vendors that are 2015 Edition fully certified to ensure you meet ACI measures. 

2019 update: CMS requires ECs to use a 2015 Edition CEHRT when reporting in 2019.

Payment Adjustment Increases to -/+5% 

2017 allowed for a 4% positive or negative penalty or reimbursement for a practice participating in MACRA. 2018 has only increased 1% in either direction. The base rate of Medicare Part B payments will increase to -/+5%.

2019 update: Payment adjustments increase to -/+7%.

Low Volume Threshold Increases  

Exemptions in 2018 are going to increase due to the guidelines that are required to participate in MACRA. Now in order to qualify for one of the MACRA programs (MIPS or APM), providers need to charge ≤$90,000 in Medicare Part B OR fewer than 200 patients annually, exempting a lot of ECs in 2018.

2019 update: A third exemption added: ≤200 covered professional services. 

Performance Threshold Increases from 3 to 15 

To avoid negative penalties for 2018 reporting period, practices will need to obtain at least 15 performance points. Good news – moving from 3 points to 15 only takes a few additional measure to be met with Quality (2-3 measures), IAs (4 measures) or ACIs (all measures).

2019 update: Practices will need at least 30 points.

Cost Category Takes Effect 

The cost category will now have weight in 2018, adjusting the other percentages for the remaining three categories:

Quality – 50%
Improvement Activities (IA) – 15%
Advancing Care Information (ACI) – 25%
Cost – 10%

2019 update: Cost increasing to 15%, Quality is decreasing to 45%. Advancing Care Information is changing to Promoting Interoperability (PI). The weights for IA and PI will be 15% and 25% respectively.

Virtual Group Participation Becomes Optional 

Eligible Clinicians (EC) have struggled to report for MACRA in 2017. Luckily for those solo practitioners, the CMS has created an easier way for them to report in 2020. Now ECs can join forces and participate in group reporting to participate in MACRA for a year. Scores and points will be awarded to each individual in the group.  The deadline to register for the 2018 virtual group reporting is December 31, 2017.

2019 update: Individual clinicians, groups, or virtual groups can participate in MACRA if they meet at least one, but not all three of the low volume thresholds (see above).

Hardships & Unforeseen Circumstances Exclusion 

2017 has seen its fair share of natural disasters from hurricanes to wildfires. The CMS understands that there are circumstances out of an Eligible Clinician's control, so to avoid penalizing those providers, the CMS has added an exemption for natural disasters or public health emergencies. Each year providers will be able to claim these hardships by December 31st of the calendar year.

2019 update: No change.

Small Business Accommodations & Incentives 

The CMS now effectively recognizes small business (15 ≥ Eligible Clinicians) with up to 5 bonus points for reporting data during 2018. Businesses will need to report on at least one performance category to be eligible.

2019 update: Bonus points will be increased to 6 and apply only to reporting in the Quality performance category.

Make sure you are up to date with other MU changes. To learn more about RxNT|EHR be sure to call 800-943-7968 option 3, email us at, or click on the “Learn More” button below. 

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