Coalition urges CMS to begin implementing virtual groups

A healthcare information technology advocacy group is urging the Centers for Medicare and Medicaid Services to implement virtual groups as a way to help small provider organizations navigate newly announced reimbursement changes and the use of IT to achieve emerging goals.

In a letter sent today to Andy Slavitt, acting administrator of CMS, Health IT Now said the groups will be essential to help providers cope with the changes. That support will be crucial, as CMS may itself struggle to cope with changes that the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will require of the agency, Health IT Now suggests.

“Implementation of the MACRA statute will be challenging for both physicians and CMS,” Health IT Now executives wrote. “Establishment of virtual group reporting options appear no different.”

In the legislation for MACRA, Congress established virtual groups to enable providers in different locations to associate as a group for reporting purposes, thus helping providers that otherwise might have problems reporting on measures under the Merit-based Incentive Payment System (MIPS). Virtual groups will particularly aid providers with limited direct patient interaction, in rural areas and those not able to report on full sets of measures for MIPS, says Health IT Now, a coalition of patient groups, provider organizations and payers.

“The knowledge gleaned from virtual group reporting might be used to identify ways to encourage provider collaboration within alternative payment models and inform the development of new models and multi-provider episodes of care,” says the letter to Slavitt, signed by Health IT Now’s Executive Director, Robert James Horne.

The MACRA statute underscores the importance of technology in “improving the functioning of and user experience with the Medicare program,” the letter noted. “Recognition of technology driven data registries and policies such as real-time physician feedback is prominently featured in the law to help facilitate new ways of accessing and delivering healthcare.”

The group’s letter also includes the suggestion that implementing MACRA also will be a challenge for CMS, as it retools its systems to handle the new reimbursement approach.

“We recognize that part of the problem may lie with the CMS legacy IT systems, which some suggest are incapable of performing many functions that are commonplace among IT systems today,” the group’s letter says. “While we believe it is imperative that Congress work with the administration to identify ways that the CMS computer system can be updated to increase Medicare’s efficiency and reduce costs, we do not believe such a barrier need impact the effectiveness of the virtual group concept.”

The group offered CMS the experience of its members in facilitating virtual groups, through the use of its members’ experience and technology.

“We would also like to identify additional ways that our members can help support your overall MACRA efforts,” the letter concluded. “Effective establishment of health IT solutions within the program, such as virtual group reporting, holds great promise for the future of Medicare.”

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