HITapproved Industry Highlights
By now you’ve probably heard that one of the outcomes of the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is that the Centers for Medicare and Medicaid Services (CMS) will be replacing the old Health Insurance Claim Number (HICN) on Medicare cards with a new, randomly generated Medicare Beneficiary Identification (MBI) code. Officially, the change is known as the Social Security Number Removal Initiative.
With the recent release of the MACRA final rule, the Centers for Medicare & Medicaid Services (CMS) confirmed that they remain committed to implementing the legislative requirements in less than 3 months, but did make some provisions to satisfy provider concerns. Briefly, the final rule said that CMS decided to increase the flexibility of the Medicare Access and CHIP Reauthorization Act (MACRA).
MIPS relies on the calculation of a composite (or final) score based on the linear combination of 4 factors (except 3 for 2017), each multiplied by its corresponding weight as explained in the more than 2000-page Final Rule. The factors and their weights for 2017 are Quality (60%), Improvement Activities (15%), and Advancing Care Information (25%).
Many people have asked me to review the Quality Payment Program final rule, released on October 14, 2016. Yes, the rule is still complex – over 2400 pages, of which more than 50% is the mandated response to comments made on the proposed rule. The good news is that CMS has been very responsive to feedback, creating a transition plan for adoption, reducing the number of criteria and extending the timeline which enables iterative learning before large scale implementation.
Now that we have had time to digest (choke on?) the MIPS 2300+ page final rule, the picture is becoming clearer. We have begun preparation efforts with the practices that we work with and you know what we are finding?
The Centers for Medicare & Medicaid Services (CMS) announced the Comprehensive Primary Care (CPC) initiative’s second round of shared savings results, with nearly all practices (95 percent) meeting quality of care requirements and four out of seven regions sharing in savings with CMS. These results reflect the work of 481 practices that served over 376,000 Medicare beneficiaries and more than 2.7 million patients overall in 2015.
Many EHR components were developed as early as 30 years ago, but it wasn’t until 2009 that the federal Meaningful Use incentive program precipitated wide-spread implementation of robust EHRs across healthcare. If the EHRs themselves are young, interoperability is still in its infancy. A large majority of acute care hospitals and other providers now have an HHS-certified EHR, providing the needed critical mass to make interoperability even possible.
The term “Digital Health” has become a catch-all to describe a whole range of new technologies that have been created in the healthcare space in recent years. Mobile Health, Telehealth, Wearable Tech, Electronic Health Records, Health Information Exchange, Big Data, Blue Button, Personal Genomics, and many more fall under the digital health umbrella.
It used to be called the “Summary of Care” but now we know it as “Health Information Exchange”. It is perhaps the most misunderstood of the Meaningful Use (MU) measures for everyone from solo docs to large health systems. I get emails everyday asking questions. Are there are any exclusions? Can I fax the information? Can I push the information to a HIE? Let’s break it down, one step at a time.