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HHS Issues MACRA Final Rule

Today, the U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) issued a final rule that emphasizes the importance of protecting public health and safety while also strengthening transparency and accountability in the ONC Health IT Certification Program (“Program”).

The “ONC Health IT Certification Program: Enhanced Oversight and Accountability” final rule will enable the ONC Health IT Certification Program to better support physicians and hospitals – the vast majority of whom use certified electronic health records (EHRs) –  and the rapid pace of innovation in the health information technology (health IT) market.

“More transparency and accountability in health IT is good for consumers, physicians, and hospitals,” said Vindell Washington, M.D., M.H.C.M., national coordinator for health IT. “Today’s final rule strengthens the program by ensuring that certified health IT helps clinicians and individuals use and exchange electronic health information safely and reliably.”

The final rule focuses on three key areas:

  • Direct Review:Provides a regulatory framework for ONC to directly review certified health IT products and take necessary action in circumstances involving: (1) potential risks to public health and safety; or (2) circumstances that present practical challenges for ONC-Authorized Certification Bodies (ONC-ACBs)—such as when issues arise involving multiple certified functionalities or products that have been certified by multiple ONC-ACBs. The final rule also focuses on corrective action plans to address issues and includes an appeals process under the Program for health IT developers that have products under direct review.
  • Consistent Authorization and Oversight:Establishes a process for ONC to authorize and oversee accredited testing laboratories (ONC-ATLs) to align with ONC’s existing oversight of ONC-ACBs, and facilitates ONC’s ability to quickly, directly, and precisely address testing and performance issues.
  • Increased Transparency and Accountability:Makes identifiable surveillance results of certified health IT publicly available to advance ONC’s overall commitment to transparency and provide customers and users with valuable information about the performance of certified health IT, including illuminating good performance and continued conformance with Program requirements.

More information on the final rule can be found here and on the ONC Health IT Certification Program here.

To find today’s Federal Register Notice of the final rule, visit: https://www.federalregister.gov/documents/2016/10/19/2016-24908/onc-health-it-certification-program-enhanced-oversight-and-accountability

October 14, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HHS Announces Major Initiative to Help Small Practices Prepare for the Quality Payment Program

Over the last few weeks, the Department of Health and Human Services (HHS) has made several important announcements related to the Quality Payment Program, which has been proposed to implement the new, bipartisan law changing how Medicare pays clinicians, known as the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. Today, we are announcing $20 million to fund on-the-ground training and education for Medicare clinicians in individual or small group practices of 15 clinicians or fewer.

These funds will help provide hands-on training tailored to small practices, especially those that practice in historically under-resourced areas including rural areas, health professional shortage areas, and medically underserved areas.

“Doctors and health care providers in small and rural practices are critical to our goal of building a health care system that works for everyone,” said Secretary Burwell. “Supporting local health care providers with the resources and information necessary for them to provide quality care is a top priority for this administration.”

As required by MACRA, HHS will continue to award $20 million each year over the next five years, providing $100 million in total to help small practices successfully participate in the Quality Payment Program. In order to receive funding, organizations must demonstrate their ability to strategically provide customized training to clinicians. And, most importantly, these organizations will provide education and consultation about the Quality Payment Program at no cost to the clinician or their practice.

“The bipartisan MACRA legislation gave us the tools to improve Medicare and make it modern and sustainable by improving the incentives for and lowering the burden on clinicians,” said Dr. Patrick Conway, acting principal deputy administrator and chief medical officer for the Centers for Medicare & Medicaid Services. “Real change must start from the ground up, and today’s announcement recognizes this reality by  getting doctors the resources they need to provide better, smarter care.”

Organizations receiving the funding would support small practices by helping them think through what they need to be successful under the Quality Payment Program, such as what quality measures and/or electronic health record (EHR) may be appropriate for their practices’ needs. Organizations would also train clinicians about the new clinical practice improvement activities and how these new activities could fit into their practices’ workflow, or help practices evaluate their options for joining an Alternative Payment Model.

“Providing these tools to help physicians and other clinicians in small practices navigate new programs is key to making sure they are able to focus on what is most important: the needs of their patients,” said B. Vindell Washington MD, MHCM, FACEP, principal deputy national coordinator. “As with the Office of the National Coordinator for health ITs funding for regional extension centers, this assistance will help health care providers leverage health information technology to enhance their practices and the care they deliver.”

Awardees will be announced by November 2016.  HHS encourages all qualified organizations to apply for this funding.

To learn more about today’s announcement and how to apply, please contactMQIDTA@cms.hhs.gov.

For more information on the Quality Payment Program, please visit:https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program.html

June 20, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Physicians Wary of MACRA’s Potential to Hasten the Demise of Independent Practices, Black Book Survey

Two-thirds of independent practices now deliberate selling out to hospital systems and larger groups or closing down by 2019 as the resource-intensive requirements of MIPS, administrative burdens, and under-optimized technology may make the transition to value-based care too discouraging.

According to a May 2016 survey of 1,300 physician groups of five or less clinicians by Black Book™, 67% of high Medicare-volume doctors foresee the end of their independence due to the so-called “doc fix” bill or “MACRA,” which repeals the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with a new value-based reimbursement system, will not have the technology, capital or staffing to sustain under the conditions of the Merit-based Incentive Payment System (MIPS).

Despite small practice education, training and technical assistance programs promised from CMS to help onboard physicians with the MACRA programs, 89% of the remaining solo practices expect to minimize Medicare volumes as to not be required to submit reports for the quality and clinical practice improvement activities or report in the cost performance category.

77% of small practices identified themselves as financially struggling currently due to physician staffing losses to larger group practices and hospital IDNs directly. 72% also blame their under-performing billing technology and compounding payment issues for their troubles.

“Physician payment based on 2017 performance isn’t scheduled to kick in until 2019,” said Doug Brown, Managing Partner of Black Book. “That’s far too long to maintain operations for the most stressed practices to hold on with outmoded technology and scarce billing support.”

The apparent solution for 78% of remaining independent primary care physicians is to join a bigger group or IDN to gain needed reporting, revenue cycle tools and support before 2019.

Black Book anticipates the EHR replacement market to decline in the small practice market as 55% of independent practitioners indicate they will make no technology shifts or purchases until they have made decisions on being acquired. “On the other hand, the growth opportunities for EHR vendors currently serving the larger practice market, IDNs and multi-specialty clinics are expected to appreciably benefit from these small practice acquisitions,” said Brown.

Based on the aggregate client experience and customer satisfaction scores on eighteen key performance indicators tuned to physician practice integration of documentation, operations and revenue cycle management the top-ranked electronic health records for small practices have changed as more cloud-based EHRs have made competitive pricing among several demands, particularly integrated billing, specialist-driven focuses, mobility, interoperability and patient satisfaction support.

63% of smaller (fewer than ten practitioners) and solo practice physicians have still not settled on a technology suite or set of products that delivers to their expectations on meaningful use, clinician usability, interoperability, and coordinated billing and claims, but over a third of those slower adopters expect to make product decisions before the end of this calendar year.

The top ranked solo/single physician practice EHRs in the 2016 survey are Kareo, Modernizing Medicine, drChrono, iPatientCare, athenahealth, CareCloud and Practice Fusion.

The top ranked EHRs for practices of 2-5 physicians are SRS Soft, ADP AdvancedMD, Practice Fusion, Amazing Charts and Allscripts.

Black Book™ surveyed over 33,000 healthcare records professionals, physician practice administrators, and ambulatory group leaders in the information technology arenas to provide EHR and practice billing system users, media, investors, quality minded vendors, and prospective buyers of practice software with a comprehensive comparison of the industry’s top respected and performing vendors. Black Book Research employs detailed key performance indicators targeted at ensuring high product and service performance through comparing vendors from the customer experience.

For comprehensive research and ranking data on medical and surgical specialties, consult http://www.blackbookmarketresearch.com for the latest customer experience results.

June 13, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.