The final MACRA rule announced on Friday by the Department of Health and Human Services includes a new Quality Payment Program tying physician payments to quality of care, which will require providers to rely heavily on healthcare information technology, according to CMS Acting Administrator Andy Slavitt.
Under the MACRA rule, Slavitt contends that the vendor community has a “vital” and unprecedented opportunity to help clinicians improve the flow of electronic health information and increase the quality of patient care.
“If the HITECH Act allowed big EHR companies to form and grow, MACRA is the next shift and arguably a much richer opportunity,” Slavitt said Friday afternoon. “Tech companies will compete to simplify and support the lives and jobs of physicians so they can be more productive, communicate better with their patients and other physicians, and have the information they need in their own workflow so they can succeed at value-based care, which is really the promise of MACRA.”
Slavitt said several of the provisions in MACRA directly relate to the use of certified health IT such as EHRs, including the Advancing Care Information performance category under the Quality Payment Program.
“The Advancing Care Information category will modernize, streamline and replace the Medicare EHR Incentive Program for eligible professionals (also known as ‘Meaningful Use’),” states an ONC fact sheet on the Quality Payment Program and HIT. “The Quality Payment Program advances the use of certified EHRs and health IT as tools to improve the flow of health information among clinicians and, ultimately, improve the quality of care provided to patients.”
Specifically, the document highlights that the Quality Payment Program’s “paths for clinicians and groups—the Merit-based Incentive Payment System (MIPS) and the Advanced Alternate Payment Models (Advanced APMs)—require use of certified EHR technology to exchange information across providers and with patients to support improved care delivery, including patient engagement and care coordination.”
Slavitt said the objectives in the Advancing Care Information performance category of MIPS emphasize measures that support clinical effectiveness, information security and patient safety, patient engagement, as well as health information exchange. However, he noted that the final MACRA rule does not require reporting on the clinical decision support and computerized physician order entry measures, while reducing the number of measures clinicians must report to five measures that are focused on interoperability—down from 18 measures in Stage 3 Meaningful Use and from 11 measures in the originally proposed rule for the Quality Payment Program.
According to Slavitt, the focus is on rewarding high-value, patient-centered care, which will be reflected in $1 billion in payments to providers in 2017 for better quality healthcare. However, at the same time, he lamented the fact that technology doesn’t yet support physicians in the way that they need.
“For physicians to be successful in value-based care, it requires technology that’s easier to use, simpler and more connected, less burdensome and intrusive, that supports the complexity of medicine but also simplifies by delivering exactly what patients and doctors need when they need it—and no more,” Slavitt said.
“Rather than prescribing innovation,” he added that vendors should be “aiming to open up the playing field to make solutions that assist in value-based care easier.” Interoperability is critical, concluded Slavitt, who concluded that industry must “open the ecosystem so physicians can select apps that work seamlessly with EHRs to address their needs.”
For its part, ONC’s 2015 Edition Health IT Certification Criteria released last year will provide the HIT foundation for the new Quality Payment Program, including interoperability-focused standards for certified EHR systems. As part of the 2015 Edition, vendors will be required to publish application programming interfaces (API) to make it easier for software programs such as mobile apps to access information from other programs.
“The Quality Payment Program recognizes and rewards the fact that health IT is foundational to providing quality care,” National Coordinator for Health Information Technology Vindell Washington, MD, told members of the press. “It’s about unlocking the data within and putting that data to work.”
ONC’s fact sheet on the new Quality Payment Program and the role of health IT can be found here.
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