Government & Policy

Step-by-step tools help providers unlock data to help prevent cardiovascular events.

Especially since participants in a recent survey indicated that they wasted time and money on measures that are not clinically relevant, some are starting to ask whether its worth it?

Medical practices spend an average of 785 hours per physician and $15.4 billion annually reporting quality measures to Medicare, Medicaid and private payers, according to a new report in Health Affairs. The study, led by researchers from Weill Cornell Medical College and funded by the Physicians Foundation, looked at the quality reporting efforts of primary care, cardiology, orthopedic and multi-specialty practices, polling 1000 of them (250 of each type), drawn at random from the membership rolls of the Medical Group Management Association. Their findings suggest that, while "much is to be gained from quality measurement, the current system is unnecessarily costly, and greater effort is needed to standardize measures and make them easier to report," researchers said. [Also: Slavitt, DeSalvo: Health IT has to work better for doctors] Practices reported spending 15.1 hours per week per physician wrangling quality measures -- 2.6 hours each week for physicians, with the rest of the work going to nurses or medical assistants. About 12 of those hours were spent logging data into medical records solely for quality reporting. Some 80 percent of practices said they spend more time managing quality measures than three years ago. Almost half said that's become a significant burden. But just 27 percent thought those measures necessarily correlated with quality care. Beyond the time invested, the dollars add up too. Weill Cornell researchers found that practices spent $40,069 per physician each year on quality reporting – totaling $15.4 billion annually. "The cost to physician practices of dealing with quality measures is high and rising," researchers said. "On top of the obscene waste of billions of dollars each year on quality measures, the most alarming thing about this study of MGMA member practices is that nearly three-fourths of the groups reported being measured on quality measures that are not clinically relevant," said Halee Fischer-Wright, MD, MGMA's president and CEO, in a statement. "The vast majority also stated current measures are useless for improving patient care," she added. "This study proves that the current top-down approach has failed. It serves no purpose to have over three thousand competing measures of quality across government and private initiatives." While care quality is essential and reporting standardization is critical, "if measures don't improve patient care, it’s an exercise in futility," said Fischer-Wright. "As the largest contributor to the problem, the federal government needs to get out of the business of dictating patient care through wasteful mandates and create simplified systems to support medical practices in improving quality across the country." As HIMSS16 in Las Vegas this past week, officials from the Centers for Medicare and Medicaid Services emphasized that quality measures would continue to be a key component in CMS' reimbursement programs. [Also: Meaningful use will still be part of MIPS reimbursement, CMS says] Kate Goodrich, MD, director of CMS' Center for Clinical Standards and Quality, said new payment rules under the Medicare Access and CHIP Reauthorization Act, or MACRA, would reimburse physicians based on a composite performance score factoring in quality measures (30 percent), resource use (30 percent), clinical practice improvement activities (15 percent) and meaningful use of information technology (25 percent). "Our intent is to have a single, unified program," she said, while acknowledging the need for flexibility and avoiding a one-size-fits-all approach: "We know physician practices are very different from one another." Earlier in the week, CMS Acting Administrator Andy Slavitt said the agency has been listening more intently than ever to physician feedback, working with those on the front lines to understand their pain points. He cited actual quotes from physicians, including one who said, "Most of what I'm doing during the day is entering data into the EHR." While offering few policy specifics, Slavitt seemed to indicate that's a message that's resonating with CMS. Doctors are "not describing problems we don't know how to solve," he said. "Job one is to bridge the gulf between our public policy work and what's actually happening with patient care. That has to become an integral part of how we do things." Twitter: @MikeMiliardHITN

U.S. Department of Veterans' Affairs CIO LaVerne Council said last week that the VA needs to reconsider whether its proprietary Veterans Information Systems and Technology Architecture is the best electronic health record for its more than 1,200 healthcare sites. Council explained during testimony to U.S. House appropriators that changes in the VA's healthcare delivery plan, such as emphasis on mobility, security and women's health, as well as connections with private sector providers, are forcing the reconsideration of VistA. Specifically, Council said it was time to "take a step back" from the planned modernization of the VistA health record and announced VA plans to review whether it should continue upgrading VistA or turn to a commercial off-the-shelf product, much the way the Department of Defense elected to forego its in-house Armed Forces Health Longitudinal Technology Application, aka AHLTA, and is replacing it with a Cerner EHR. [Like Healthcare IT News on Facebook] “We have not made up our minds about VistA,” Council said. When asked during a separate hearing last week by Montana Democrat Sen. Jon Tester why it’s taking so long to either fix or replace VistA, VA undersecretary David Shulkin, MD, explained that Council “has gone in with her private sector background and really challenged all of the assumptions that frankly have led to an underperforming part of the organization.” Council and Shulkin’s comments come after the Government Accountability Office published recommendations in Late February that both VA and DOD “develop and compare the estimated cost and schedule of their current and previous approaches to creating an interoperable electronic health record and, if applicable, provide a rationale for pursuing a more costly or time-consuming approach.” Twitter: @HealthITNews

Whereas a democrat would be more prone to simple tweaks, a republican would opt for tax credits, Romney said, acknowledging that since Obamacare is the law of the land it would would be hard to go back to his preferred model under which the states decide how to insure their citizens.

Barely a year after announcing its ambitious plan to tie reimbursement to quality of care, the U.S. Department of Health and Human Services announced Thursday that 30 percent of Medicare payments are now tied to alternative payment models, such as ACOs.  

Donald J. Trump, the frontrunner in the race to become the Republican presidential nominee, today released a very broad outline of a plan with few details that he, if elected president, would seek to implement to replace the Affordable Care Act.

While the former presidential candidate called the 2016 race anything but over, as for his own entry into the race, the answer is 'no.'

Providers range from linking some payments to the effective management of a population to full population-based management.

A new agreement with FHA will allow DirectTrust's federal partners to operate their Direct implementations within its Security and Trust Framework.