Meaningful Use

On Twitter, former National Coordinator for Health IT Farzad Mostashari, MD, called it the "most substantive change to how healthcare is paid for in a couple of decades." The propsed MACRA rule put forth by the U.S. Department of Health and Human Services on Wednesday also holds some pretty big changes for how health IT can be put to work by physicians to drive quality improvement and cost efficiencies. [Also: MACRA proposed rule published by HHS, streamlining federal programs including meaningful use] "By proposing a flexible, rather than a one-size-fits-all program, we are attempting to reflect how doctors and other clinicians deliver care and give them the opportunity to participate in a way that is best for them, their practice and their patients," said Patrick Conway, MD, chief medical officer at the Centers for Medicare & Medicaid Services, in announcing the rule. "Reducing burden and improving how we measure performance supports clinicians in doing what they do best – caring for their patients." So far, most industry reaction to the notice for proposed rulemaking is positive – recognizing the fact CMS seems to have taken the feedback from more than 6,000 frontline healthcare stakeholders to heart, crafting a rule that's attuned to the needs of physicians. In a statement, HIMSS applauded the "significantly streamlined reporting and the acknowledgement process for MIPS-eligible clinicians" in the new rule. "We are encouraged by CMS's effort to coordinate reporting periods across federal programs and the decision to align with the ONC Interoperability and Certification Programs," HIMSS officials said. "With the first MIPS performance full-year reporting period expected to begin on January 1, 2017, we're further analyzing the MACRA rule to ensure that Medicare providers will be able to meet the proposed requirements." American Medical Association President Steven Stack, MD, meanwhile, said it's "hard to overstate the significance of these proposed regulations for patients and physicians." In particular, he was pleased that CMS has been listening to physicians’ concerns and "has made significant improvements, by recasting the EHR meaningful use program and by reducing quality reporting burdens." American Health Information Management Association CEO Lynne Thomas Gordon released a statement saying AHIMA supports the MIPS progam's "emphasis on interoperability, information exchange and security measures, which we believe are critical to reaching the rule’s stated long-term goal of ‘better care, smarter spending, and healthier people.'" The Premier healthcare alliance was less pleased, however – specifically taking issue with one part of the two-pronged MACRA approach to value-based care: its provisions related to advanced payment models, or APMs. CMS "made a significant mistake in not including any bundled payment or Track 1 Medicare Shared Savings Program ACOs as qualifying advanced payment models under MACRA," said Blair Childs, senior vice president of public affairs at Premier Inc. "Rather than rejecting bundled payment programs, we believe CMS should focus on ways to alter the bundled payment programs to demonstrate use of certified EHR technology and align measures with other Advanced APMs. "We also believe CMS seriously erred in excluding Track 1 MSSP ACOs in the APMs for failing to meet the more than 'nominal risk' financial requirement," said Childs. "As we've learned through members in our Population Health Management Collaborative, these programs require providers to not only forego revenue through a lower volume of services, but also investment millions of dollars in redesigning care through new technologies, data analytics, additional staff, etc.," he said. "We think most businessmen would call that more than nominal risk, yet CMS choses to define it as only cases where there is risk to the government." Elsewhere in the Twitterverse, the response was mostly positive – with some skepticism and a bit of I-told-you-so mixed in. And "Meaningful Use" is going "away" by changing its name to "Advancing Care Information" #MACRA #livetweeting as I read the proposed rule — Joy Rios (@askjoyrios) April 28, 2016 or basically what #MU should have been from day 1 @Travis_Broome — Harold Smith III (@haroldsmith3rd) April 28, 2016 1/Bottom Line #MACRA NPRM Game changer. Lots of great changes, 100's of thoughtful details and decisions. Biggest blind spot can be fixed — Farzad Mostashari (@Farzad_MD) April 27, 2016 Really good YouTube "whiteboard" connecting the dots of our MACRA announcement. Plain English. No acronyms. Wow. https://t.co/qLHSpYnWRX — Andy Slavitt (@ASlavitt) April 27, 2016 A tree died for this #MACRA #MIPS #Medicare pic.twitter.com/YsiSd3R9Mf — Amanda Narod (@AmandaBinDC) April 28, 2016

The U.S. Department of Health and Human Services issued a long-awaited proposed rule for the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, on Wednesday, ushering in some big changes for the ways physicians are assessed for quality of care and use of information technology.    

Denise Hines, executive director of the Georgia Health Information Network announces some exciting professional news on ​HIMSS Radio and highlights the Women in Health IT initiative.

The Office of the National Coordinator for Health IT said it can harness data it already has to help providers make better electronic health record purchasing decisions.

U.S. Senators and Representatives introduced a bill on Wednesday that would reduce the meaningful use reporting period from a full year to 90 days – and do so in 2016, a move pressed by healthcare organizations across the country. Sens. Rob Portman and Michael Bennet and Reps. Renee Ellmers, Tom Price, Bobby Rush and Ron Kind introduced bipartisan legislation. CHIME, the Medical Group Management Association, the National Rural Health Association, the Federation of American Hospitals and physician groups, not only support the bill, but have also pressed lawmakers for it. Many of the organizations wrote CMS on March 15, asking for a 90-day reporting period for 2016. [Also: Healthcare providers press CMS for 90-day meaningful use reporting] “A preliminary yet critical step to facilitate increased provider success, we respectfully request CMS adopt for the 2016 reporting year the same 90-day reporting period policy for participants in the Meaningful Use program that was offered in 2015,” they wrote to CMS Acting Administrator Andy Slavitt. CMS required a full year reporting period last year, but later reduced the requirement to 90 days in a rule that also reduced the number of meaningful use, Stage 2 requirements. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

National Coordinator Karen DeSalvo, MD, is stepping away from the co-chair role on the ONC Health IT Policy Committee. Kathleen Blake, MD, vice president of performance improvement at the American Medical Association, will replace DeSalvo, according to Politico, which reported the announcement was made Tuesday at the joint meeting of the Health IT Policy and Standards Committees. Blake will serve alongside DeSalvo's current co-chair, Paul Tang, MD, chief innovation and technology officer at the Palo Alto Medical Foundation. Tang is also the head of ONC's meaningful use workgroup.  [Also: How satisfied are you with your EHR? Satisfaction Survey results]  DeSalvo currently serves as both National Coordinator for Health IT and Acting Assistant Secretary of Health and Human Services. She's been with ONC since January 2014. Health and Human Services Secretary Sylvia Burwell brought DeSalvo to HHS in October 2014 to help coordinate the federal government respond to the Ebola outbreak – touting her public health qualifications after having served as New Orleans Health Commissioner in the wake of Hurricane Katrina. In May 2015, President Barack Obama appointed DeSalvo HHS Acting Assistant Secretary for Health. If she gets a Senate confirmation hearing and is approved, she would step down from the National Coordinator post at ONC.   Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Starting in 2019, Centers for Medicare & Medicaid Services, will change how they pay physicians in a profound way. Unfortunately, the details are complicated and confusing, and many of the particulars have yet to be worked out, which has led many healthcare leaders to glaze over the details and focus on more immediate concerns.

Company executives say that joining Cerner, Epic, Meditech and others in promising to use agreed upon standard and not block data is merely formalizing what they already practice.  

Remember ONC Regional Extension Centers? There were 62 of those federally-funded organizations, better known as RECs, created nationwide in 2009 with a mission of helping primary care physicians move from paper to digital systems. In 2009, Morehouse School of Medicine was awarded a $21 million from the Office of the National Coordinator for Health Information Technology to become the only REC in Georgia to provide on-the-ground technical assistance for individual and small medical practices. News out of Atlanta today is that the Georgia center, GA-HITEC, part of the National Center for Primary Care at Morehouse School of Medicine, is closing in on getting the job done. The Georgia REC has reached 100 percent of the eligible primary care providers in the state and 89 percent of its eligible critical access and rural hospitals have achieved Stage 1 meaningful use. [Also: Most RECs plan to stay open for business] Through the program, it has reached more than 4,000 eligible primary care physicians and 56 critical access and rural hospitals by employing a 10-Step Roadmap to meaningful use. Also, it has assisted members in receiving more than $80 million in incentive payments through the federal EHR incentive programs. "Through our quest for Health IT interoperability we have provided the Georgia medical community increased patient engagement and improved quality health care through the use of technology," said Dominic Mack, MD, GA-HITEC's principal investigator and newly named director of the National Center for Primary Care at Morehouse School of Medicine, in a news release. He added that the work of the team would result in both better clinical outcomes and improved population health outcomes. As the national REC program is slated to sunset in late 2016, GA-HITEC continues to develop activities in support of CMS' HIT initiatives, including Stage 2 and Stage 3 meaningful use, health information exchange, clinical practice transformation, along with other value-based reporting efforts. And, GA-HITEC is not alone. Most RECs plan to stay open, according to the 2014 HIMSS Regional Extension Center Survey. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Looking into its crystal ball – or perhaps digital spreadsheets – PiperJaffray analysts see big plays in the RCM market. That potential is so large, in fact, that Cerner alone has a $40 billion opportunity, and it ranks fifth in market share.