I’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai, and Suzhou. The twelve hour time difference means that I can work a day in China, followed by a day in Boston. For the next 7 days, I’ll truly be living on both sides of the planet. I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days. I’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance for implementation of MACRA/MIPS, but here’s the excellent 26 page synopsis created by CMS which provides an overview of the 1058 page rule...
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
See the following -
Does Healthcare Need a More Modern Way to Define and Measure EHR Interoperability?
Diana Manos | Healthcare IT News | August 18, 2016
KLAS executive vice president Taylor Davis said that measuring interoperability can get messy because the EHR market is currently immature. Industry experts and the federal government are divided on the best way to assess the state of the nation’s health IT interoperability. The Office for the National Coordinator for Health IT, for instance, has proposed using CIO surveys to gauge the status of interoperability among and between healthcare organizations...
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Does Healthcare Need a More Modern Way to Define and Measure EHR Interoperability?
Diana Manos | Healthcare IT News | August 18, 2016
Industry experts and the federal government are divided on the best way to assess the state of the nation’s health IT interoperability. The Office for the National Coordinator for Health IT, for instance, has proposed using CIO surveys to gauge the status of interoperability among and between healthcare organizations. To that end, ONC posted a Request for Information (RFI) on how to best assess interoperability that closed last month — just not before drawing some sharp comments from across the industry...
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Halamaka Takes a Deep Dive on the MACRA NPRM
By John D. Halamka, MD | May 5, 2016
As promised last week, I’ve read and taken detailed notes on the entire 962 page MACRA notice of proposed rulemaking (NPRM) so that you will not have to. Although this post is long, it is better than the 20 hours of reading I had to do! Here is everything you need to know from an IT perspective about the MACRA NPRM...What is the MACRA NPRM trying to achieve with regard to healthcare IT? The MACRA NPRM proposes to consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for eligible professionals (EPs), creating a single set of reporting requirements. The rule would sunset payment adjustments under the current PQRS, VM, and the Medicare EHR Incentive Program for eligible professionals...
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Halamka Discusses Three Disruptive Care Coordination Innovations In Use at Beth Israel
By John D. Halamka, MD | July 20, 2016
Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse. The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data. However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem...
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Halamka Pays a Visit to Oscar Health
By John D. Halamka, MD | August 10, 2016
Today I’m in New York City visiting Oscar Health, on my continuing quest to determine how best to integrate digital platforms, patient-family engagement, and care coordination in preparation for MACRA/MIPS and the transformation from fee for service to alternative payment models. At the moment, there is no single magic bullet, but there are early innovations that hold promise. At BIDMC we’ve thought the best approach to care management is to identify a cohort with a disease, then enroll that cohort in a program which involves tracking progress against guidelines/protocols, deploying telemedicine/visiting nurses, and measuring data from home-based devices...
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Halamka Summarizes the CMS Meaningful Use Final Rule
By John D. Halamka, MD | October 20, 2015
I’ve been asked to summarize the 752 page CMS Meaningful Use Final Rule...Between the Notice of Proposed Rulemaking and the publication of the CMS Final Rule, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed to include sunsetting the Meaningful Use payment adjustment for professionals at the end of 2018. Also, MACRA requires the establishment of a Merit-Based Incentive Payment System (MIPS) which would incorporate Meaningful Use. The comment period will be used in an attempt to align the Meaningful Use program and the MIPS program...Stage 3 is more controversial and I will focus on that.
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Halamka's Reflections on US Health IT Policy Trajectory
By John D. Halamka, MD | July 6, 2017
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Health IT Security, FHIR Focus of ONC Secure API Server Challenge
Elizabeth Snell | HealthIT Security | October 10, 2017
ONC is challenging healthcare stakeholders to build secure Fast Healthcare Interoperability Resources (FHIR) servers to improve health IT security and ensure that secure FHIR options are available in the future. The Secure API Server Showdown Challenge will ideally “identify unknown security vulnerabilities in the way open source FHIR servers are implemented,” ONC Office of Standards and Technology Director Steven Posnack, MS, MHS, wrote in a blog post...
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HHS Awards $100 Million to Boost Community Health Center Quality
Bernie Monegain | Healthcare IT News | August 19, 2016
A total of 1,304 health centers across 50 states and the District of Columbia will divide $100 million to help boost healthcare quality, the U.S. Department of Health and Human Services announced. The funds are earmarked to expand quality improvement systems and infrastructure and to improve primary care service delivery...
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How Does the ONC Define HIE, Value-Based Care, Population Health?
Jennifer Bresnick | HealthIT Analytics | September 29, 2016
The new ONC Health IT Playbook contains a wealth of resources and information for healthcare organizations in various stages of reform. From the very beginning stages of negotiating an EHR purchase to the complex integration of multiple care sites into a risk-based financial arrangement, there’s something for everyone at every level in this interactive, online compendium of knowledge...
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How to Fix the EHR Mess
Matthew Hahn, MD. | MatthewHahnMD.com | June 12, 2017
Computers, more specifically, electronic health records (EHRs), will someday revolutionize the practice of medicine. In fact, successful computerization of medical care is the most critical step necessary to transform the American health-care system from its current sorry state to the 21st century system of our dreams. It is ironic, then, that today EHRs represent one of the worst problems plaguing medical professionals. At this point, many physicians would say that EHRs have created more problems than they have fixed. The most important question is how do we get from where we are to where we need to be?...
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It Is Time for Physicians to Fight Back. Now.
Matthew Hahn | Kevin MD | May 14, 2017
The American health care system is broken, but it is not really “health care” that is the problem. The science of medicine, the tests, and the treatments available are better than ever. It is health care bureaucracy that is the problem. But doctors, nurses, and patients bear the brunt of the dysfunction. Medical professionals are unable to practice, and patients are denied the care they need, even though it is readily available. Careers are being ruined, and lives lost along the way. It is time to fight back...
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MACRA: Big Fix or Big Problem?
J. Michael McWilliams, MD, PhD | Annals of Internal Medicine | May 16, 2017
In January 2017, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) took effect, ushering in a new system for physician payment in Medicare. With MACRA, policymakers ended the Sustainable Growth Rate (SGR) method for updating physician fees in Medicare and provided a permanent “doc fix,” relieving Congress of its annual duty to override substantial fee cuts that the SGR would have imposed. In place of the SGR, MACRA instituted the Merit-based Incentive Payment System (MIPS), which intends to reward clinicians for providing higher-quality and lower-cost care...
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Making Sense of MACRA: A Glossary of New Medicare Terms
Press Release |
American Medical Association |
December 5, 2016
As John Harvey, MD, FACS, past president of the Medical Association of Georgia, has toured his state to discuss the upcoming Medicare payment transition, he has noticed a trend. “More than half the physicians I have talked to … were not aware of the terms MACRA, MIPS and APMs.” Of course, there are also QPP, ACI and numerous non-initialisms that refer to crucial elements of the law that repeals the sustainable growth rate. Following is a short list of the terms every physician should know before the new payment rules take effect Jan. 1...
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Not So Fast: CMS Says Meaningful Use Not Dead, New Incentive Program Will Take Time
Mike Miliard | Healthcare Finance | January 20, 2016
One week after Andy Slavitt said meaningful use would be replaced soon, the acting Centers for Medicare and Medicaid Services administrator and national coordinator Karen DeSalvo made it clear that the changes would take time and that providers must still follow the current program. Slavitt and DeSalvo in a blog post Tuesday afternoon explained the new regulatory framework would move away from measuring clicks to focusing on care...
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