New Proposed MACRA Rule Renovates Information Technology Use

April 28, 2016 - The Department of Health & Human Services (HHS) has proposed new rules regarding the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) which will essentially remove the meaningful use program and move forward in advancing health information technology use among medical facilities.

Specifically, the meaningful use program will no longer be utilized among physicians treating Medicare beneficiaries by January 2017. Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt mentioned during a media call that CMS will be moving away from standard regulations of electronic health record use and ensuring that patient care is advanced through more connected and coordinated technology.

The program at hand is called Advancing Care Information and, if passed, it would go into implementation by January 1, 2017 along with other parts of the MACRA legislation. While the meaningful use program will essentially be removed from physician practices, it will still play a role in treating Medicare beneficiaries within hospitals.

Slavitt along with Dr. Karen DeSalvo, National Coordinator at the Office of the National Coordinator for Health IT (ONC), wrote for The CMS Blog How EHR Incentive Programs have made a significant impact on revolutionizing the electronic technologies and health IT solutions available across hospitals and medical facilities.

When it comes to implementing MACRA Legislation, CMS and ONC are looking to move past the EHR Incentive Programs and take full advantage of the many opportunities health IT solutions bring to the table.

These federal agencies spoke with more than 6,000 stakeholders to determine the future of meaningful use and MACRA. They listened to both the positive and negative feedback when creating the new proposed rule.

The proposed rule will have a greater focus on implementing the Merit-based Payment System (MIPS) in a way that remains patient-centric and brings more incentive toward health IT connectivity. Healthcare providers should be aware that their reimbursement will be based on a new vision for the future, explains Slavitt. This vision is based on ensuring that physicians, clinicians, and patients themselves are able to share relevant information to better coordinate medical care.

CMS and ONC are attempting to improve interoperability so that doctors are able to exchange information between different physician offices even when patients see a variety of providers. Additionally, the federal agencies are seeking vendors to sell user-friendly technologies that allow doctors to continue interacting with patients in a personalized and flexible manner.

Slavitt and DeSalvo mention on The CMS Blog that the new proposed rule and the Advancing Care Information program will reduce burden among healthcare providers by providing a more flexible and simpler approach to handling information technology.

The federal agencies are seeking to allow healthcare providers to essentially choose the measures they’d like to be regulated on so that their reimbursement shows “how technology best suits their day-to-day practice.”

“It is hard to overstate the significance of these proposed regulations for patients and physicians. When Congress overwhelmingly passed MACRA last year, lawmakers signaled that they wanted to transform Medicare by promoting flexibility and innovation in the delivery of care, changes that could lead to improved quality and better outcomes for patients,” Steven J. Stack, M.D., President of the American Medical Association, said in a public statement.

“Our initial review suggests that CMS has been listening to physicians' concerns. In particular, it appears that CMS has made significant improvements by recasting the EHR Meaningful Use program and by reducing quality reporting burdens.”

“Today’s draft rules are only a first step in the rulemaking process and with many physicians awaiting guidance on how these rules will affect their practice, the AMA is launching comprehensive, online resources to help navigate the changes and drive successful implementation for physicians.”

“The existing Medicare pay-for-performance programs are burdensome, meaningless and punitive.  The new incentive system needs to be relevant to the real-world practice of medicine and establish meaningful links between payments and the quality of patient care, while reducing red tape.”

“The 60-day comment period will provide physicians with an opportunity to offer constructive recommendations to share the final regulations that will be issued in the fall.  The AMA will continue its engagement with CMS during the comment period so that MACRA can live up to its promise.”

The biggest areas that lawmakers will be emphasizing when it comes to health information technology is the need for interoperability, health information exchange, and addressing data security protocols. Some physicians will also be exempt from quality reporting if EHR technology is not applicable to their practice and various doctors’ offices will be able to report their performance as a group.

This new proposed rule is going to affect physician practices when it comes to Medicare reimbursement but does not touch Medicaid payments nor hospital procedures. The future vision of health information technology should be achievable with the participation between vendors, health IT entrepreneurs, physicians, federal agencies, and the patient community.

The new proposal is likely to bring more care coordination, interoperability, and real-time data information sharing between multiple physician practices, which will ultimately improve the quality of care and reduce wasteful healthcare spending.