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MACRA Video Training – MACRA Monday

Posted on June 19, 2017 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 did a quick search on YouTube for the term MACRA and it found 23,300 search results. It’s not surprising to find so much MACRA content. It seems to me that healthcare has an insatiable appetite for MACRA information.

While it’s great that so many organizations are producing MACRA content, no doubt some of it is not all that valuable and a bunch of it isn’t accurate. Case in point, the first video returned in the YouTube search for MACRA was a video from eClinicalWorks (eCW). Is there anyone that would want eCW to train them on government regulations after the recent eCW settlement that revolved around their decision to not properly certify their EHR and the meaningful use program? Maybe all the information is accurate, but that’s not where I’d go to for my source of MACRA information.

If you wanted a really brief, high level overview of MACRA, I found this 2 minute cartoon video from MediSync to be a nice intro to the intent of MACRA:

If you want a much more in depth look into MACRA’s MIPS program, you’ll want to check out Answers Media’s 25 videos in their The ABCs of MIPS series:

We all know that the government MACRA website is the first place to go for really high quality MACRA information. Do you have another go to source for your MACRA information that we should know about? Let us know in the comments.

Will the eCW Settlement Impact MACRA? – MACRA Monday

Posted on June 12, 2017 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 case you missed it, eCW settled a whistleblower lawsuit for $155 million. At the core of the lawsuit were the Medicare meaningful use payments that were paid to eCWs customers. The lawsuit alleged that eCW had been inappropriately certified as an EHR and told their customers that they were appropriately certified.

Many in the industry including myself are suggesting that eCW isn’t the only EHR vendor that could run into these types of issues. It’s quite easy for an EHR vendor to pass the EHR certification test. It’s another thing to have actually implemented all of the EHR certification requirements. We’ll see what other lawsuits come forward.

What does this settlement mean for MACRA?

Before the eCW settlement, many in the EHR industry didn’t realize their risk profile because their customers were getting government money. Once your customers start taking government money, the legal framework really changes. This is going to be true with the MACRA program as well.

It behooves every EHR vendor to really make sure they are following the spirit of the law and not just trying to game the EHR certification process (which we all know is easily gamed). I expect that most EHR vendors will step up their game and make a good faith effort to comply. I think this is the hope of the US Attorney’s office given their press release about the settlement.

We’re still waiting to see if the eCW settlement will cause any issues for eCW users who attested with the inappropriately certified eCW software. My prediction is that they’ll be fine, but some have argued that their meaningful use incentive payments could be pulled too. If that happens, that could really impact participation in the MACRA/MIPS program.

You can be sure that healthcare organization’s compliance officers are going to spend more time verifying their EHR vendor’s certification. I wouldn’t be surprised if we saw some new contracts that include some new language to cover the healthcare organization if their EHR has issues similar to eCW.

One other thing that might be an issue is those organizations that choose to switch to a new EHR from eCW. EHR switching has always been an issue when it comes to meaningful use and now MACRA and MIPS. We’ll have to dive into EHR switching and MACRA in a future post.

What impact do you think the eCW settlement will have on MACRA?

New MIPS Eligibility Tool – MACRA Monday

Posted on June 5, 2017 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.

If you aren’t sure about your eligibility for MACRA (Quality Payment Program if you prefer), then check out CMS’ new tool which will help you see if you can participate in MIPS. In fact, you can check if anyone is eligible to participate in MIPS if you know their NPI number (which is easily available with a search on Google). Here’s the output I got for a provider that I looked up:

Pretty straight forward. This doctor can participate in MIPS as an individual or with his group. It would be really nice if this screen also informed the doctor about the penalties and bonuses they could receive depending on how they choose to approach MIPS. However, I guess they would have to be careful about how specific they were with that data since anyone can search any provider. However, even some generic details on the penalties and/or incentives would be a smart addition to this screen. The “What Can I Do Now?” button does lead to some more information, but it’s not very compelling.

I liked this friendly reminder from @JournalofCP:

MACRA and MIPS are upon us. How are you approaching it?

ACP Offers Recommendations On Reducing MD Administrative Overload

Posted on March 30, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As everyone knows, physicians are being overwhelmed by outsized levels of administrative chores. As if dealing with insurance companies wasn’t challenging enough, in recent years EMRs have added to this burden, with clinicians doing double duty as data entry clerks after they’re seen patients.

Unfortunately, streamlining EMR use for clinical use has proven to be a major challenge. Still, there are steps healthcare organizations can take to cut down on clinicians’ administrative frustrations, according to the American College of Physicians.

The ACP’s recommendations include the following:

  1. Stakeholders responsible for imposing administrative tasks – such as payors, government and vendors – should analyze the impact of administrative tasks on physicians. If a task is found to have a negative effect on care quality, needlessly questions a clinician’s judgment or increases costs, it should be challenged, fixed or removed.
  2. If an administrative task can’t be cut, it must be reviewed, revised, aligned or streamlined to reduce stakeholders’ burden.
  3. Stakeholders should collaborate with professional societies, clinicians, patients and EMR vendors to develop performance measures that minimize needless clinician burden and integrate performance reporting and quality improvement.
  4. All key stakeholders should collaborate in reducing, streamlining, reducing and aligning clinicians’ administrative tasks by making better use of health IT.
  5. As the US healthcare system shifts to value-based payment, stakeholders should consider streamlining or eliminating duplicative administrative demands.
  6. The ACP would like to see rigorous research done on the impact of administrative tasks on healthcare quality, time and cost; on clinicians, staff and healthcare organizations; patient and family; and patient outcomes.
  7. The ACP calls for research on best practices for cutting down on clinicians’ administrative tasks within both practices and organizations. All key stakeholders, including clinician societies, payors, regulators, vendors and suppliers, should disseminate these evidence-based best practices.

It appears that even the federal government has begun to take these issues to heart. According to Modern Healthcare, late last year CMS announced a long-term initiative intended to reduce physicians’ administrative burdens.  Then-acting CMS Administrator Andy Slavitt said the initiative would hopefully make it a bit easier for practices to meet the requirements of the Quality Payment Program under MACRA.

But other sources of administrative frustration are likely to linger for the foreseeable future, as they’re deeply ingrained in stakeholder business processes or simply difficult to change.

For example, the American Academy of Family Physicians notes that some of the biggest aggravations and time wasters for its members include the need to get prior authorizations from health plans and outdated CMS documentation guidelines for E/M services which don’t leverage EMR capabilities. Sadly, I wouldn’t hold my breath waiting for either of those problems to be solved.

Still, it seems some healthcare organizations want to take on the administrative overhead problem. The University of Pittsburgh Medical Center has launched an initiative aimed at reducing the number of computer-related tasks doctors have to perform. According to the Pittsburgh Post-Gazette, UPMC is partnering with Microsoft to minimize physicians’ need to do electronic paperwork. Executives with the two organizations say this effort should result in tools for both doctors and patients.

Will MACRA Be Repealed or Replaced? – MACRA Monday

Posted on March 27, 2017 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 heard a lot of doctors still suggesting that MACRA is going to disappear. I’ve heard every argument imaginable, but the most common one is that the Trump administration is going to get rid of MACRA. While I can understand this fear, I don’t think it has any real foundation. In fact, I think the opposite is true.

As Neil Versel aptly points out, the Repeal and Replace legislation that didn’t quite make it through the house was silent on healthcare IT. I love how Neil puts it:

Wondering what the proposed American Health Care Act—the Republican plan to “repeal and replace” the 2010 Patient Protection and Affordable Care Act—says about health IT?

Nothing. It says nothing.

Wondering what the American Health Care Act says about promoting innovation in healthcare?

Nothing. It says nothing.

Wondering what the American Health Care Act says about holding providers accountable for the care they deliver or about moving away from the inefficient—and often dangerous—fee-for-service reimbursement model?

You guessed it. Nothing. Nada. Zero.

The closest things we’ve heard about the new administration impacting healthcare IT is Tom Price saying that he wants MACRA to not put undue burden on doctors and the possibility that ONC could be on the chopping block.

The former is something that every person at HHS has said for years. No doubt Tom Price is a more provider-friendly HHS secretary than past administrations but given the legislation, I don’t think Tom Price will change MACRA much. As to the later, even if they get rid of ONC, that doesn’t mean MACRA will disappear. It’s still the law of the land. MACRA would just move to another part of HHS. Look at it more as a corporate reorg versus something that will significantly impact MACRA.

All in all, the fact that technology was never really part of the repeal and replace discussion gives me more confidence that MACRA isn’t going anywhere. What do you think? Will MACRA survive? Are there other factors that could influence MACRA’s future?

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

GAO: HHS Should Tighten Up Its Patient Data Access Efforts

Posted on March 23, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The Government Accountability Office has issued a new report arguing, essentially, that while its heart is in the right place, HHS isn’t doing enough to track the effectiveness of patient health data access efforts. The report names ONC as arguably the weakest link here, and calls on the HHS-based organization to track its outreach programs more efficiently.

As readers know, CMS has spent a vast sum of money (over $35 billion at this point) to support health IT adoption and health data access. And while these efforts have spilled over to some patients, it’s still an uphill battle getting the others to access their electronic health information, the GAO report says.

Moreover, even patients that are accessing data face some significant challenges, including the inability to aggregate their longitudinal health information from multiple sources into a single, accessible record, the agency notes. (In other words, patients crave interoperability and data integration too!)

Unfortunately, progress on this front continues to be slow. For example, after evaluating data from the 2015 Medicare EHR Program, GAO researchers found that few patients were taking a look at data made available by their participating provider. In fact, while 88 percent of the program’s hospitals gave patients access to data, only 15 percent of patients actually accessed the information which was available.  When professionals provided patients with data access, the number of patients accessing such data climbed to 30 percent, but that’s not as big a delta as it might seem, given that 87 percent of such providers offered patient data access.

Patient reluctance to dive in to their EHI may be in part due to the large number of differing portals offered by individual providers. With virtually every doctor and hospital offering their own portal version, all but the most sophisticated patients get overwhelemed. In addition to staying on top of the information stored in each portal, patients typically need to manage separate logins and passwords for each one, which can be awkward and time-consuming.

Also, the extent of data hospitals and providers offer varies widely, which may lead to patient confusion. The Medicare EHR Program requires that participants make certain information available – such as lab test results and current medications – but less than half of participating hospitals (46 percent) and just 54 percent of healthcare professionals routinely offered access to clinician notes.

The process for sharing out patient data is quite variable as well. For example, two hospitals interviewed by the GAO had a committee decide which data patients could access. Meanwhile, one EHR vendor who spoke with the agency said it makes almost all information available to patients routinely via its patient portal. Other providers take the middle road. In other words, patients have little chance to adopt a health data consumption routine.

Technical access problems and portal proliferation pose significant enough obstacles, but that’s not the worst part of the story. According to the GAO, the real problem here is that ONC – the point “man” on measuring the effectiveness of patient data access efforts – hasn’t been as clear as it could be.

The bottom line, for GAO, is that it’s time to figure out what enticements encourage patients to access their data and which don’t. Because the ONC hasn’t developed measures of effectiveness for such patient outreach efforts, parent agency HHS doesn’t have the information needed to tell whether outreach efforts are working, the watchdog agency said.

If ONC does improve its methods for measuring patient health data access, the benefits could extend beyond agency walls. After all, it wouldn’t hurt for doctors and hospitals to boost patient engagement, and getting patients hooked on their own data is step #1 in fostering engagement. So let’s hope the ONC cleans up its act!

Encouraged By Political Changes, Groups Question ONC Functions

Posted on March 21, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Riding on an anti-regulation drive backed by the White House, groups unhappy with some actions by ONC are fighting to rein it in. President Trump has said that he would like to see two regulations killed for every new reg, and the groups seemingly see this as an opening.

One group challenging ONC activities is HealthIT Now, a coalition of providers, payers, employers and patient groups.

In a letter to HHS Secretary Tom Price, Health IT Now argues that ONC exceeded its authority last year, when it backed an oversight rule designed to boost the certification process by evaluating vendor interoperability capabilities.

The 2016 rule also holds health IT vendors accountable for technology flaws that could compromise patient safety, an approach which, HITN argues, steals a move from federal agencies such as the FDA. The group also contends that ONC has not been clear about its criteria for critiquing HIT solutions for safety problems.

Meanwhile, a group of medical societies and specialties is asking federal health officials to hold off on 2015 EHR certification requirements, which providers are expected to start using January 2018, for at least one year. The group notes that since ONC released its final 2015 Edition requirements, few vendors – in fact, just 54 of 3,700 products currently certified – have fully upgraded their systems.

Given this situation, rushing to deploy the latest certification requirements could create big problems, including a major disruption to medical practices’ business, the coalition argues.

If they’re forced to choose from the small number of systems which have upgraded their platforms, “physicians may be driven to switch vendors and utilize a system that is not suitable for their specialty or patient population,” the group said in a letter to CMS acting administrator Patrick Conway, MD, and acting ONC national coordinator Jon White, MD.

In addition to addressing certification concerns, there’s much the federal government can do to support health IT improvement, according to attendees at HIMSS17.

According to HITN, attendees would like policymakers to address interoperability, in part by reviewing Meaningful Use and the ONC Voluntary Certification programs; to focus on improving patient identification systems, and avoid imposing barriers to private market solutions; to clarify the role of the ONC in the marketplace; and to encourage the use of real-world evidence in healthcare and health IT deployment.

As I see it, these ideas veer between close-in detail and broad policy prescriptions, neither of which seem likely to have a big effect on their own.

On the one hand, while it might help to clarify ONC’s role, authority and process, the truth is that the health IT market isn’t living or dying on what it does. This is particularly the case given its revolving door leaders with too little time to do more than nudge the industry.

Meanwhile, it seems equally unlikely that the federal government will come up with generally-applicable policy prescriptions which can solve nasty problems like achieving health data interoperability and sorting out patient matching issues.

I’m not saying that government has no role in supporting the emergence of health IT solutions. In fact, I’m fairly confident that we won’t get anywhere without its assistance. However, until we have a more effective role for its involvement, government efforts aren’t likely to bear much fruit.

MACRA and MIPS Training and Resources – MACRA Monday

Posted on March 20, 2017 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 we’ve covered a lot of ground in this MACRA Monday series, there are still a lot of details we haven’t covered. I’ve been debating how deep into the weeds of MACRA and MIPS we should go or not as part of this series. We’d love to hear your thoughts.

We’re partially reticent to go really deep, because there’s a lot of great resources out there to dive deeply into MACRA and MIPS. Plus, we don’t see many people doing higher level strategic decision making content that has opinions about what your organization should or shouldn’t do when it comes to MACRA.

If you’re looking for some deeper training on MACRA and MIPS, we’ll highlight a few courses and trainings out there that we know about.

4Med MIPS and MACRA Training
The people at 4Med have a whole series of training for MIPS and MACRA. They have a lot of past experience doing training for meaningful use and PQRS and they’re continuing that with their latest MACRA and MIPS Training. Here’s a look at some of the courses they have coming up (Note: each of these links automatically gives you a discount on each course):

MACRA-MIPS Quality Project Manager – Starts March 29 – A nice course focused on the quality portion of MIPS.

Patient Centered Medical Home (PCMH) Workshop – Starts May 3 – This goes beyond MIPS and MACRA, but is all part of the related trend.

HIPAA Compliance Officer – Starts April 19 – This isn’t really a MIPS and MACRA course, but they require you to do a HIPAA Risk Assessment, so this course could help you make sure you’re ready to fulfill that requirement. Plus, this is a good course given the importance of security in healthcare these days.

4 Med offers a number of other courses including an Advancing Care Information course as well, but it’s not scheduled right now. We’ll update you in the future as those courses are scheduled. Instead of the live training options above, you can also purchase the online version of these courses. If you use the promo code: HITC you’ll get 20% off those online versions.

MIPS Boot Camp
Another option to consider is this MIPS Boot Camp course offered by Jim Tate and Wayne Singer. The course is only 1.5 hours, but Jim is a true expert in this area and so it will be a great starter course. They obviously are trying to push their MyMipsScore™ App, but that might be something useful for readers as well.

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 Do Doctors Need to Know About MACRA and MIPS? – MACRA Monday

Posted on March 13, 2017 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 HIMSS 2017 conference, I had a chance to do a video interview with MACRA expert, Alexandria (Alex) J. Goulding, Public Policy Manager at iHealth. We cover a broad range of MACRA topics focused on the practical things that doctors should know about MACRA and MIPS.

You can find the full MACRA video interview at the bottom or click any of the links below to skip to a specific answer:

Do you have other perspectives and insights that you’d add to what Alex Goulding offered above? Please share 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.

A New MACRA Tools Market – MACRA Monday

Posted on March 6, 2017 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.

One thing we’ve realized writing MACRA Monday is that there’s an insatiable appetite for MACRA right now. Webinar signups are through the roof when it’s on the topic of MACRA and MIPS. MACRA and MIPS training courses are selling like hot cakes. Everyone is trying to get the information they need to deal with MACRA and MIPS.

After talking with many companies at HIMSS, there’s a whole new market being created for tools that help organizations track and attest for MACRA as well. Of course, every EHR vendor is creating a solution for their providers. However, there are a lot of other companies that are looking at this as a big opportunity for them to provide tools to make tracking and reporting MACRA and MIPS easy.

Two companies that I ran into recently in this space are SA Ignite and SPH Analytics.

Both of these companies are focusing on MACRA, APM, and MIPS reporting at the higher end. We’re talking about hospital systems that have 100 medical practices and so they have a few hundred doctors who need to do MACRA reporting. Can you imagine managing that many attestations on Excel or something? That’s why I think these tools are going to become so popular.

A part of me hates that entire companies are being created around government attestation. However, the realist in me understands that these tools are needed by large health systems that have to comply with government requirements or lost a lot of money.

What do you think of this trend? Is it a microcosm of our current healthcare system? Do you know of other tools that can help organizations trying to handle MACRA reporting?

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