Staying In the Know on MACRA

As a follow up to our last post, we want to give an update on the state of MACRA’s Merit-based Incentive Payment System and reporting tips. First, let’s address continued year 1 reporting.

Data Submission
Given feedback from clinicians across the country, CMS is working to lessen reporting confusion and burden. The center recently launched a data submission system for Quality Payment Program (QPP) participation. With the new platform, clinicians will need to create a login to submit and manage year 1 data, which is due by March 31, 2018. The system will connect clinicians to the Taxpayer Identification Number (TIN) associated with their National Provider Identifier (NPI) as eligible clinicians report either as individuals or a group. The system provides immediate feedback with real-time scoring as data is entered. However, scoring may change based on additional data input or new quality measure submission. To learn more, check out CMS’ QPP 2017 Data Submission Factsheet.

MIPS’ Future
Though CMS recently unveiled QPP year 2’s final rule, the group is now accepting recommendations for new specialty measure sets or revisions for 2019’s MIPS program year. CMS will accept suggestions until Feb 9, 2018.

While program planning moves along, pushback from the Medicare Advisory Board (MedPAC) arose. The advisory body to Congress recently suggested replacing MIPS with an alternative program model that is less burdensome and complex for participants. Meeting notes are here, and no changes have been officially made.

As each MACRA public discussion and policy adjustment occurs, clinicians may find more and more uncertainty. Our goal is to keep readers in the know, so they can focus on quality patient care.

Staying afloat as a CIO amidst industry pressures

Across the country, over 80 percent of healthcare organizations now have an EHR system in place. While initial implementation no longer serves as a major issue, with the new technology comes added CIO pressures, including reimbursement program requirements, technology disparities and security challenges.

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Reimbursement reporting challenges

With year 1 of the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP) well underway, the healthcare industry forges ahead in the transition to value-based care reimbursement. While the shift aims to advance patient care, many providers find themselves swimming in reporting requirements or completely oblivious to the program altogether. According to a NueMD survey, 50 percent of physicians are unfamiliar with the reimbursement legislation, and 49 percent have never encountered any information about it at all.

IT can help clinical care fill in knowledge gaps by facilitating assessment of current patient care and technology practices that meet QPP measure requirements. By strategically aligning data capture, maintenance and analysis with outlined QPP measures while looking ahead to potential year 2 program leniencies, providers can ease burden. With a little preparation, IT can help find the low-hanging fruit for the reporting quick wins that will help avoid QPP penalties while maximizing the program’s financial bonuses.

Rural health disparity

As value-based care requirements elevate, critical access, small and rural healthcare providers lag behind. From 2008 to 2015, only one-third of hospitals surveyed by the American Hospital Association had at least eight of 10 performance management EHR functions in place. Just 33 percent of hospitals with fewer than 100 beds adopted such systems.

Discrepancies in technology advancement between rural or small providers and large medical systems creates a digital divide across the country. Small providers face the decision of closing shop, joining group purchasing arrangements, becoming part of ACOs or sticking it out on their own. These struggling providers need continued representation in HIT policy and government regulations beyond progress with the 21st Century Cures Act for vendor transparency or MACRA’s QPP year 2 leniencies.

Cybersecurity concerns

While advancing technology is vital for new patient care needs and expectations, its growing significance also puts healthcare providers at risk. In a recent MGMA survey, only 55 percent of healthcare professionals have confidence in their organizations’ IT infrastructures against cyber attacks, while almost one-third have faced a cyberattack.

As healthcare ranks poorly at 13th in U.S. industries for cybersecurity practices, more and more HIT departments are turning to outsourcing expertise. Total IT budget spent on outsourcing has increased from 10.6 percent in 2016 to 11.9 percent in 2017. Now, healthcare organizations are turning to third-party advisors to train and certify staff on security best practices, while partnering with external security providers and adding defense tools to the HIT suite of applications.

Despite these three areas of concern, by strategically planning for value-based care requirements, today’s healthcare CIO stand better equipped against mounting pressures, while assessing market trends, turning to third-party expertise and staying on top of industry policy change.