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APM Expansion and New PTAC Committee – MACRA Monday

Posted on November 28, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Most of the general details about APMs was changed in the final rule (See our previous post about APMs and whether you should take part in an APM or MIPS within MACRA). However, if you want to dive into the details of APMs, then check out this CMS webinar and slides that dive into the APM program. One thing that didn’t change much yet is the types of programs that counted as possible advanced APMs:

  • Shared Savings Program (Tracks 2 and 3)
  • Next Generation ACO Model
  • Comprehensive End Stage Renal Disease Care Model (Two-Sided Risk Arrangements)
  • Comprehensive Primary Care Plus (CPC+)
  • Oncology Care Model (OCM) (two-sided risk track)

However, as CMS mentioned previously, their goal is to get more and more people involved in the APM program. As part of that effort, a number of other programs are likely to be eligible as an advanced APM in 2018:

  • Comprehensive Care for Joint Replacement (CJR) Payment Model (CEHRT)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT)
  • ACO Track 1+
  • New Voluntary Bundled Payment Model
  • Vermont Medicare ACO Initiative (as part of the Vermont All-Payer ACO Model)

In fact, some of these might even be available in 2017. The MACRA final rule also created a new committee called the PTAC (Physician-Focused Payment Model Technical Advisory Committee). This committee will accept suggestions on other programs that should be considered an advanced APM. Then, they make recommendations to the HHS secretary on which programs should be added as Advanced APMs.

All updates on programs that qualify as an Advanced APM will be available on the CMS Quality Payment Program (MACRA) website.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

What Will Be Trump’s Impact on MACRA? – MACRA Monday

Posted on November 21, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Next week we’ll be kicking off our weekly series of details from the MACRA Final Rule. However, before we start going through the changes and what you need to know about MACRA, I wanted to cover an important topic of concern for many practices. I’ve heard a lot of practices that are afraid of what they consider the uncertain future in the coming Trump presidency.

While I believe that healthcare could see significant impact from a Trump presidency, I don’t believe that MACRA will be impacted by the change in presidency. First, MACRA was as bipartisan as you could find in Washington DC. Even if Trump wanted to replace, modify, repeal MACRA, I can’t imagine it getting enough support in the senate and house. If this is true, Trump won’t even try to do anything with MACRA. Second, Trump has plenty of bigger fish to fry. When you look at the various priorities that Trump has said he has for his presidency, nothing indicates that MACRA will be anywhere near those priorities. Third, it’s hard for me to imagine that Trump would see a problem with the move to technology in healthcare.

What also is worth noting is that MACRA is separate from ACA (aka Obamacare) and even ARRA (the HITECH Act). I’ll leave the predictions for what will happen with ACA for other people. I have no doubt that ACA will be impacted by the change in presidency, but even if they did a full repeal of Obamacare (which looks like it’s impossible), MACRA will still remain and be in force. If MACRA was part of Obamacare, I’d have a different view, but since it’s not then I think MACRA will continue forward as planned.

Those of you hoping for MACRA to disappear due to the new president and those of you waiting for MACRA to change after the comment period is over are grasping at straws. Love it. Hate it. Feel however you may about MACRA, I really don’t see any scenario where MACRA is not part of the future of healthcare.

What do you think? If you disagree, I’d love to hear why in the comments. If you agree, I’d love to hear from you as well. With that view, we’ll be continuing MACRA Monday blog posts for the foreseeable future so that our readers are ready.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

What the Final Rule Means for Small Practices – MACRA Monday

Posted on November 14, 2016 I Written By

This guest blog post by John Squire, President and COO of Amazing Charts, is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

With the long-awaited issuance of the MACRA Final Rule earlier this month, the Centers for Medicare and Medicaid Services (CMS) tried to soften the blow for small practices in the first year of the program. Depending on the 2017 data you submit by March 31, 2018, your 2019 Medicare payments will be adjusted up, down, or not at all. This flexible timeline casts a wide net and should get everyone to participate.

Here’s a breakdown of all the options for 2017, from opt-out to maximum bonus, open to a small practice using a 2014 Certified EHR Technology (CEHRT). As you’ll see the sections get longer as we progress since each stage becomes more complex.

Be excluded from Medicare’s Quality Payment Program
In the Final Rule, CMS increased the exclusion threshold from $10,000 or less in Medicare Part B allowed charges, to $30,000 or less in billings, or seeing fewer than 100 Medicare Part B patients during the 2017 calendar year.

CMS estimates that this change will exempt approximately 30 percent of eligible clinicians from the Quality Payment Program. If you fall below the threshold, CMS will automatically exclude you. If you don’t meet the exclusion criteria, keep reading.

Do nothing… and take a penalty
Unlike previous programs such as Meaningful Use, there is no opt out for MACRA. If you don’t meet the exclusion requirement above, you are subject to downward adjustments. The Merit-based Incentive Payment System (MIPS) is the most likely option for small practices.

MIPS has a scale of 100 points. If you don’t report on any 2017 data by March 31, 2018, you’ll earn zero points and receive a four percent downward adjustment on your Medicare payments in 2019. This penalty rises over time, becoming five percent in 2020, seven percent in 2021, and nine percent in 2022!

A small minority of providers might be willing to make this financial sacrifice, but the vast majority of small practices using CEHRT are more likely to take a few simple steps to avoid the penalty.

Test out for a neutral outcome
You can avoid a downward adjustment by reporting just one quality measure, attesting to one improvement activity, or attesting to the four required Advancing Care Information (ACI) measures (formerly Meaningful Use) – for any length of time period in the calendar year of 2017. You’ll earn three points and there will be no downward adjustment to your 2019 payments.

This is a no-brainer for most small practices. If you use a 2014 Certified EHR, you’re already doing many of these activities, such as e-Prescribing, today. Belong to a Health Information Exchange? You’ve just earned your three points.

Participate for a bonus
You can earn four to 100 points for the chance of a small, moderate, or high positive adjustment to your payments in 2019. Submit at least 90 days of data on more than the minimum (i.e. on two or more quality measures, two or more improvement activities or more than the required four advancing care information measures) to earn more than three points.

Basically, the more information you submit over the longer length of time translates to more points and the more points you earn, the larger a positive adjustment on your payments will be, up to the maximum of four percent.

To earn the most possible points, (1) report for a full year on at least six quality measures (or a measure set); (2) attest to improvement activities worth 20 or 40 points (depending on the geography, size and make up of your practice); and (3) attest to all four of the required ACI measures as well as the five optional ACI measures, plus the one bonus ACI measure. Every 2014 Certified EHR technology has the functionality to support all ten ACI measures.

It could be easier than you think
CMS allows you to get a bonus for ACI when you use 2014 CEHRT to complete one of 94 eligible activities from the eight improvement activities categories. These include telehealth services, care coordination, or any kind of population health management. It could be something as simple as setting a flag for regular check-ups for your Medicare/Medicaid dual-eligible patients. A complete list can be found at this excellent CMS resource: https://qpp.cms.gov/measures/ia.

Even better news: providers participating in a patient-centered certified medical home (PCMH) will automatically receive full credit for the practice improvement category of MIPS. Similarly, providers participating in an Advanced Alternative Payment Model (APM) like an accountable care organization (ACO) will receive 50 percent of the full score for the practice improvement category.

Don’t get complacent – start today
While the agency’s idea of implementing a transition period was necessary, providers in small practices can’t get complacent. The formula for success is going to change very quickly. January 1, 2018 brings the full-year reporting requirement on the expanded measures.  The quality measures will still be required and the cost measures (previously called “resource use”) are going to dial up.  The year 2022 is only six years away, so unless the provider prepares next year, they could start facing some rather significant penalties.

About John Squire
John Squire, President and COO of Amazing Charts, has more than 27 years of high tech industry experience, 15 of them in Health IT. Before joining Amazing Charts, John was Senior Director of Alliances and Cloud Strategy for Microsoft’s U.S. Health and Life Sciences Business Unit.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

Should More Doctors Think About MACRA Like Med School? – MACRA Monday

Posted on November 7, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

While at the recent MGMA Annual conference I ran into Dr. Robert Wah at the CSC Health booth. Dr. Wah has a fascinating background as the former President of the AMA and was also the first Deputy National Coordinator for Health IT back in the Brailer days before now becoming Global Chief Medical Officer at CSC. No doubt he’s seen the full evolution of healthcare IT.

During our chat, Dr. Wah expressed some concern about doctors decision to not properly prepare for MACRA. Between the Pick Your Pace options which basically mean doctors don’t have to fully participate in 2017 and the MACRA final rule being published with a comment period, many doctors have decided to just sit back and not worry about MACRA for now. Those doctors argue that they should wait until the comment period is over to see if the final rule will be changed or they just figure they’ll worry about MACRA in 2018 when they have to fully participate.

Dr. Wah explained to me that this is a dangerous strategy for doctors to employ. He then compared this strategy to medical school. Dr. Wah said that medical students realize pretty early on that they can’t just cram for a class the day before the test in medical school. If students get behind in their studies, then it’s really hard for them to catch up before the test.

Dr. Wah argues that this is what many doctors are doing with MACRA and it could lead to problems. Much like in medical school, it won’t be possible to “cram” for MACRA right before a doctor must fully participate in 2018. Instead, doctors need to use 2017 to appropriately “study” for the MACRA test that’s coming in 2018.

Thanks to Pick Your Pace, CMS have given doctors a pretty big window to make sure that they’re ready for everything that’s required with the full MACRA requirements in 2018. Those that sit on their hands in 2017 will be complaining about how hard MACRA is in 2018. Those that fully participate in 2017 will likely not worry much about the MACRA requirements in 2018.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

MACRA Final Rule – MACRA Monday

Posted on October 31, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

On Friday, November 4, 2016 at 3:00 PM ET (Noon PT) Healthcare Scene be hosting a live video interview with three MACRA experts. Many of you might have seen our earlier interview with these three experts where we made predictions on the MACRA final rule and also talked about the challenges practices will face with MACRA. Now that the MACRA final rule has been published, we’re going to do a follow up interview to see where we were right and wrong and also talk about changes that came out in the MACRA final rule.

The great part is that you can join my conversation with this panel of experts live and even add your own comments to the discussion or ask them questions. All you need to do to watch live is visit this blog post on Friday, November 4, 2016 at 3:00 PM ET (Noon PT) and watch the video embed at the bottom of this post or you can watch on YouTube directly. The conversation will be recorded as well and available on this post after the interview.

Here are a few details about our panelists:

2016-november-macra-final-rule

We hope you’ll join us live or enjoy the recorded version of our conversation. Understanding MACRA and evaluating how your practice should approach MACRA is going to be crucial to the success of your organization. Join us so you can learn the latest insights and perspectives on the MACRA final rule.


(To Ask Questions, visit the YouTube page)

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

MACRA Fallout and Physician Burnout – MACRA Monday

Posted on October 24, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

I’ve been traveling the past week and still haven’t had time to fully process the MACRA final rule. In fact, it might take me a few weeks to really get things together around what’s in the final rule. It’s better that I take my time and make sure I provide you accurate information than to post early and perpetuate bad information. So, I appreciate your patience.

In the mean time, we’ll still continue on with MACRA Monday talking about some of the impact of the MACRA rule and interesting comments on what’s happening with MACRA. Today I wanted to highlight the vitriol I’ve seen online by many physicians towards MACRA. It’s been pretty ugly.

If I’m being fair to MACRA, most of the hatred has to do with the wave of government regulations and the changes happening across all of healthcare and not just MACRA. In many cases, it just seems that MACRA is the straw that broke the proverbial camel’s back. However, I’ve seen first-hand from more physicians than I can count, a real anger towards MACRA.

I do temper these experiences with the fact that so many physicians barely even know that MACRA exits. That’s not true for the ones complaining on social media, but it definitely feels like even many of those doctors barely realize what is in MACRA (with a few notable exceptions). Instead of specific complaints, they are mostly general complaints about government regulation.

Sadly, I think it kind of reminds me of my experience talking with my 12-year-old son. He’s at the stage of life where no matter what I say as a father he wants to say the opposite. I can literally say something nice to him like “You’re smart” and without even thinking about what I said he’ll knee jerk react “No, I’m not.” It makes no sense and is absolutely frustrating as a parent.

My guess is this is how the people at CMS feel when they hear doctors talking about MACRA. If MACRA was just free government money with no work, my gut is that many doctors would say it’s awful without even looking at the details. Doctors are so burnt out on government regulation that they denounce it without as much as a second thought.

Given some of the past track record, doctors have good reason to react the way they do. Can you point to very many places where meaningful use made a doctor’s life better? There are quite a few general EHR benefits, but very few specific meaningful use benefits. In fact, you can make a strong case that meaningful use added a lot of overhead and almost no value to patients or doctors. Given that, should we be surprised that doctors are afraid of more government regulation?

I’m not surprised, but with that said I also don’t think that MACRA will be the disaster that many make it out to be. In fact, I think it’s an extension of business as usual. This is particularly true in the first year of MACRA where almost no one will get penalized thanks to the MACRA Pick Your Pace options. We’ll see if that creates a pileup in future years.

I’m torn since I think we’re entering one of the most exciting times to be in healthcare. The technologies that are hitting healthcare are quite extraordinary. What we’ll be able to do with the data we’re collecting and will be able to collect in healthcare is going to surprise us all. However, on the other hand regulations are creating a burden on providers that is causing what could be irreparable harm.

Reminds me of that famous line, “It was the best of times, it was the worst of times.”

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

New Eligibility Exclusions in the MACRA Final Rule – MACRA Monday

Posted on October 17, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Last week on Friday, we posted the various resources available for the MACRA Final Rule. As you can imagine, one weekend isn’t nearly enough time to process what’s in the final rule. It’s going to take weeks to really get through it all. In fact, we might take a few weeks off from MACRA Monday to process it all.

That said, we wanted to do a quick post this MACRA Monday to talk about the new eligibility requirements and thresholds in the MACRA final rule. For reference, here’s our previous post that looked at MIPS eligibility in the MACRA proposed rule.

In the final rule, it looks like there are still 3 categories of exceptions: new doctors, low medicare volume and participation in an advanced APM. The big change in the MACRA final rule is what is considered low medicare volume. In the proposed rule it said, “$10,000 and providers care to 100 or fewer Medicare patients in a year.” Note the “and” in that requirement. In the MACRA final rule it excludes doctors with less than or equal to $30,000 in Medicare Part B allowed charges or less than or equal to 100 Medicare patients.” Note the “or” and the move from $10k in Medicare volume to $30k in Medicare volume.

With these three exceptions, Andy Slavitt sent the following tweet:

I quickly commented, “Now you’re going to get the small practices complaining that they were excluded from the incentives. #MACRA #CantWin” CMS’s MACRA executive summary says that they considered allowing those that were below these levels to opt into MIPS if they desired, but they “determined that it was inconsistent with the statutory MIPS exclusion based on the low-volume threshold.” I think the complaining for not being allowed to participate will be pretty minimal. 4% of such a small volume of Medicare won’t be that impactful for most.

There’s the start of our analysis of the MACRA final rule. A good first step to knowing if you qualify to participate in MACRA. Let us know if there are changes in the final rule that you’ve noted or that are bothering you. We’d love to hear them in the comments.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

MACRA Final Rule Is Out – MACRA Monday (on Friday)

Posted on October 14, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We usually wait until Monday to do our weekly MACRA Monday blog posts. However, today the MACRA final rule dropped and so we thought we’d do MACRA Monday on a Friday. Since the rule just came out this morning, we haven’t had a chance to do much analysis. No doubt we’ll do a lot more analysis, summarizing, etc in the future. For this post, I just wanted to share with you the various places you can go to find the final rule and summaries of the final rule that will be helpful.

The first resource you need is the MACRA final rule itself. Yes, it’s 2398 pages, but remember that CMS is required to respond to the feedback that was given in the proposed MACRA rule. The rule itself is much shorter, but the explanation of the rule is quite long. As Andy Slavitt noted, it’s long in the interest of transparency.

The reality is that most of you will only want to check out the MACRA Final Rule Executive Summary. It’s only 24 pages and should give most people what they need to know about the MACRA final rule. You can leave the 2398 page final rule to the health IT policy wonks.

Along with the executive summary, CMS has put out a new website with resources, education, and tools for the Quality Payment Program (Or as we call it, MACRA). The Education and Tools page has some great resources for those wanting to learn more about MACRA.

If you plan to participate in MIPS, then you’re likely going to use the Explore Measures page. Considering MACRA’s increase in the number of measures, this page will help you navigate through the various measures and decide which measures you’re going to do as part of MACRA.

If you want a higher level look at what CMS did to put together the MACRA final rule, take a second to read through Andy Slavitt’s letter to Clinicians. We might disagree with the details of MACRA, but after reading letters like this it’s hard to argue that Andy Slavitt and his team aren’t listening to providers and healthcare’s feedback on these rules.

That’s all for today. Happy reading this weekend! Over the next months and years we’ll be diving into the details of the program. If you’re reviewing the final rule like us, share any insights or findings you find interesting in the comments. It takes a large community to understand new rules like this.

Overview of the Advancing Care Information Category in MIPS – MACRA Monday

Posted on October 3, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

In our last edition of MACRA Monday we covered 3 of the 4 categories that are part of MIPS: Quality Performance, Resource Use (Cost), and the new Clinical Practice Improvement Activities Category. This week we’ll be covering the details of the 4th category known as Advancing Care Information.

The Advancing Care Information category is probably one you’ve heard about since it’s the replacement for the well known meaningful use program. One change that will be available in the Advancing Care Information category that wasn’t available in meaningful use is that you may participate as an individual or as a group. It’s also worth noting that the Advancing Care Information category makes up 25% of the total MIPS composite score.

One thing that can be a little confusing about MIPS is that the Advancing Care Information category has a score within a score. Advancing Care Information makes up 25% of the MACRA score, but in order to calculate how much of the 25% you’ll receive you have to figure out how many points you receive in the Advancing Care Information category. This chart illustrates how the points will be calculated:
advancing-care-information-scoring-for-macra
As you can see from this chart, your base score, performance score, and any bonus points will be used to calculate whether you receive the full 25% for your MIPS composite score or not.

The base score requires that you report your participation in the following items:

  • Protecting PHI
  • ePrescribing
  • Patient Access
  • Patient Engagement
  • HIE
  • Public Health and Clinical Data Registry Reporting

The good thing about the base score is that you’ll receive full credit for each item if you submit the reports for each item. There’s no threshhold required.

The performance score focuses on the following areas:

  • Patient Electronic Access
  • Coordination of Care through Patient Engagement
  • HIE

Unlike the base score, the performance score will need to achieve certain performance in order to receive points. You’ll also notice that these three areas indicate CMS’ efforts to focus on patient access and health data exchange.

A few other high level things to note for the Advancing Care Information category. First, they’ve removed the “All or Nothing” approach that existed in the EHR (Meaningful Use) program. Second, they’ve removed redundant measures to try and streamline the program. Third, they’ve eliminated CPOE and CDS objectives. Finally, they’ve reduced the number of required public health registries.

As you can see from the list above, this will not be that different than meaningful use. So, if you’ve been participating in meaningful use, then advancing care information won’t be a huge obstacle. If you haven’t been participating in meaningful use, well then you have some work to do.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

President’s Message for National Health IT Week #NHITWeek

Posted on September 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week is National Health IT Week. I’m not sure why we need a week for it. Some of us celebrate health IT all year round. That said, at least it’s an opportunity for some people that could impact healthcare IT to take some time to think about it. A good example of this was that President Obama put out a letter for National Health IT Week (Side Note: It’s kind of funny that it’s still a “letter” and not a blog post or Tweet or Snap or something else. It’s interesting how letters keep subsisting in electronic format. Hmm…sounds a bit like healthcare.). Here’s an excerpt of what he said:

During National Health IT Week, we recommit ourselves to improving the health of our citizenry using the breakthrough technologies of our time and reaching for the next frontier of innovation…Because of our collective efforts, 97 percent of our Nation’s hospitals and three-quarters of doctors are using electronic records to care for their patients…These efforts help advance our Administration’s goal of fostering the seamless and secure flow of electronic health information when and where it is needed most. Though there is more to be done to realize a healthcare system that fits each of our needs, I am confident that if we continue working together, we can build a future of greater health and prosperity for coming generations.

While I’d like to think that this week has caused the President to spend some time thinking about healthcare IT, I’m not sure it really makes any difference. Besides the fact that some staffer or ONC itself probably did most of the work for the letter, the letter illustrates to me that the President doesn’t really understand the challenges that face healthcare IT. That’s unfortunate because it means we won’t see any real push to change things from him.

Just to be clear, I’m not saying the President should be an expert on healthcare IT and I’m certain that few people in Congress know much more about it than he does. They’re all likely in the same position the President is in with too many challenges and limited time. They can only dive in deeply on so many of them.

The thing that disturbs me about this letter is that it’s likely the same position that our government has had for health IT since pre-meaningful use. In fact, it’s likely why meaningful use was included so easily in the ARRA stimulus package. Is Health IT good? Well, electronic has been good in every other industry. So, that sounds good. Can you transfer bits and bytes of health data better than paper? Yep! So, EHR should make sharing data easier. Conclusion: Let’s keep doing more EHR and healthcare will be better and healthcare data sharing will happen.

It’s this naivety that’s gotten us where we are today.

My cause for optimism is that the people in government positions over healthcare like Andy Slavitt, Acting Director of CMS, do have a much better pulse on what’s happening in healthcare IT. They understand physician burnout. They understand overwhelming doctors with unnecessary and useless documentation. They understand data blocking and the pressures healthcare organizations face to not share health data. I’m not saying they have all the solutions. These are challenging problems, but I’m hopeful because they do understand these problems much better than most people give them credit.

Will we see much change? The jury is still out. Those at HHS only have so many levers they can pull. I do hope they can find ways to encourage without stifling innovation. I hope they focus on collecting useful data as opposed to possibly useful data. I hope they stop wasting money on EHR certification which provides no benefit and causes a lot of harm and they instead focus on a meaningful EHR interoperability certification.

Most of all, I hope they’re not afraid to focus on one thing that’s extremely valuable and doable (ie. interoperability) and set aside the 100s of other things which have questionable value. Wouldn’t we all rather have CMS do 1 thing really well as opposed to doing 100 things poorly?

Today I focused on some government health IT perspectives. Tomorrow I’ll talk about some of the other healthcare IT trends that get me excited and a few that scare me. Happy National Health IT Week!