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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?

MIPS Eligibility Letters and Physician Reputation – MACRA Monday

Posted on May 22, 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.

Anshu Jindal has a great post up on the My MIPS Score website that talks about the MIPS Eligibility letters that so many people have been waiting for to know if they are required to participate in MIPS or if they are exempt from participating in MIPS.

Here’s a sample eligibility letter that they shared:
MIPS Eligibility Letter from CMS

There are a number of interesting options available based on if your group TIN is eligible to be included in MIPS or not and if your providers are eligible or not at the NPI level. In the post mentioned above, Anshu does a nice analysis of the financial impact of choosing to participate in MIPS at the TIN level vs the individual provider level or vice versa. The financial impact can be quite large for your organization and so you’ll want to go through that post and see what this means for your practice.

As they also mention in their post, the short-term financial impact of not participating in MIPS could be more than most people realize. However, not having a MIPS composite score could have an even larger impact on your long-term reputation. The more I’ve considered this idea, the more I’ve realized that a lot of practices that choose to opt out of MIPS are going to get blindsided by this.

This is true for those that choose the most basic pick your pace option as well. When a potential future patient sees that you have a very low MIPS score on one of the consumer facing physician rating websites, they’re not going to know how to appropriately assess what a low MIPS composite score means. They’ll naturally (and quite often incorrectly) assume that a low MIPS composite score means that you’re a poor doctor. Most of these rating websites aren’t going to educate their end users on how to properly interpret the MIPS score and your reputation will suffer if you have no score or if you purposefully choose to get a low score.

I know quite a few doctors who are choosing to not participate in MIPS out of principle. In some areas where there is more demand for doctors in their specialty than supply, then it might not be a huge issue. However, in a lot of areas, not participating in MIPS could potentially have a significant impact on your reputation. Sad, but true.

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 Insights from Around the Twittersphere – MACRA Monday

Posted on May 8, 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.

For this week’s MACRA Monday, I thought I’d offer some insights and perspectives on MACRA from around the Twittersphere. There’s a lot of information about MACRA shared on Twitter and here are some of the best ones I found.


I admit that I’d never heard of BKDHelathcare before, but this 2 minute video offers some good insights into the MACRA decision making process.


SA Ignite is one of the top companies working on MACRA reporting tools. So, it’s no surprise that they’re producing some great content on how to approach MACRA, MIPS and APMs. I hadn’t thought about tracking MIPS even if you’re in an APM, but SA Ignite offers a number of good reasons why organizations might want to consider doing both.


I love a good infographic. We’ve covered most of this in MACRA Monday, but this might be useful for those of you who are just catching up with the details.


The above is a politically correct plea from a doctor. There are other pleas that are a little stronger:


and…

Unfortunately, the rebel forces currently aren’t large enough to move the needle. We’ll be watching to see if that changes.

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 Burnout – MACRA Monday

Posted on May 1, 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.

It’s May 2017 and I’m already burnt out of MACRA. Does anyone else feel this way? The MACRA program has just gotten started and I’m already pretty sick and tired of talking about the details. I can only imagine how a doctor feels at this point. It feels a little bit like groundhog day doesn’t it?

I’m sure much of what contributes to this is the layers and layers of government requirements that we’ve had to go through over the past 5-6 years. It started with meaningful use and PQRS and then we realized there were multiple stages of meaningful use. We’ve been through stage 1 and stage 2. Of course, related to that is all the EHR certification regulation. Then, ICD-10 hit us upside the head. We worked through it, but it wasn’t fun and didn’t add much value to our patients or our organizations. Now we’re hit by MACRA. Aren’t we all just a little tired of these regulations?

Don’t get me wrong. Healthcare is a highly regulated industry, so this is the norm. Plus, I’m not saying that practices should just shun MACRA. Most practices I know need to at least avoid the penalties. So, they’ll have to participate, but I don’t know a single doctor that’s excited about the benefits of any piece of the MACRA legislation. That should tell us something and we should listen.

Think about what an achievement that is by MACRA. Doctors aren’t excited about any of it. It’s actually kind of embarrassing to think about. If you are a doctor that’s excited about some piece of MACRA and especially MIPS, I’d love to hear about it. How is any of it going to improve care, lower costs, or improve productivity? I’ll be waiting in the comments, but I certainly won’t be holding my breathe.

How sad that millions of dollars and millions of hours are going to be wasted on a legislation that isn’t too hard, but also doesn’t add value. That’s a travesty and I don’t see it changing.

I’m trying to think what would reinvigorate organizations. Is there a legislation that doctors would get excited about? That’s a hard thing to crack, but the best I could do is interoperability. What if we scraped all of MACRA and just focused on penalizing organizations that aren’t sharing data with each other.

Even this change would leave a lot of people wondering the exact value. However, there’s a pretty solid case to be made that exchanging healthcare data could improve care and lower costs. Those are things that people can get behind.

All of this said, I’m not expecting any changes. MACRA is here to stay and EHR vendors and healthcare organizations are going to have to grind it out and participate. However, that doesn’t make the MACRA burnout any less poignant.

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 Stats – MACRA Monday

Posted on April 17, 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 love a good stat. I realize that you can make stats tell you whatever you want. However, if you look at them with a critical eye, you can learn something about both the organization producing the stat and the population that the stat represents.

It’s no surprise that I found these MACRA stats shared by David Chou to be of great interest and a perfect MACRA Monday discussion.

The stat that stands out to me is the 51% of physicians who reported that they weren’t getting paid on a performance basis or that their compensation had a very small performance based piece to it. For those of us following the cutting edge of what’s happening in the world of healthcare, it’s sometimes important to remember that while the shift to value based reimbursement is happening, it still has a long ways to go.

I found David Chou’s tweet with these stats interesting when he said “Most physicians prefer the old model of payment vs MACRA.” I would look at these stats a bit differently than David.

I would suggest that these stats say that doctors prefer reimbursement models they understand and ones that pay them well. This is proven out in the stat that 71% of physicians surveyed would participate in value-based payment models if offered financial incentives to do so. It’s not really a shocking insight that doctors are happy to shift models if there are financial incentives to do so.

The challenge is that most doctors don’t think that a value based reimbursement model is going to pay them more for the work they do. They’re probably right. This explains why nearly 8 in 10 physicians surveyed prefer fee-for-service or salary for their compensation. If a new model came along that would pay them more than their current fee for service model, then they’d happily switch models.

Sometimes we make things too complicated. Physicians just want to be paid well for the work they do. Sounds like all of us no? The concern for most physicians is that these models are unlikely to pay them more. In fact, it’s quite possible they’ll pay them less or at least pay them the same for more work.

I haven’t seen any plan or projections to pay doctors more. In fact, the rhetoric in society is that we pay too much for healthcare (which is true). As a society, we all agree that we should be paying less for healthcare. However, as a healthcare provider or healthcare organization the idea of paying less for healthcare translates to getting paid less. Who’s going to take the hit when it comes to getting paid less? Providers? Hospitals? Pharma? Med device companies? Health IT Companies?

Could value based reimbursement models theoretically cost less and pay all of these stakeholders the same amount of money because patients were healthier? Works great in theory, but looking at the past history of these programs tells another story. So, it’s no wonder that most doctors would happily stay in the fee-for-service reimbursement world they know vs moving to value based reimbursement models.

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 Quick Look at MACRA in the Twittersphere – MACRA Mondays

Posted on April 10, 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.

MACRA is still an extremely hot topic and so there’s a lot of discussion about it happening on Twitter and other social media platforms. For today’s MACRA Monday I thought I’d highlight a number of tweets about MACRA that might help you in your efforts.


This was one of the main reasons that doctors didn’t want to participate in meaningful use. Seems like it’s carrying over into MACRA. Is there reason to be concerned?


I thought this was an interesting way to breakdown the two parts of MACRA: APMs and MIPS. I’d just add that APMs require the new entities to report as well. You can’t get away from reporting in either of them.


Leavitt Partners has a deep perspective on what’s happening with healthcare. In the link they assert that MACRA may have a bigger direct impact on physicians and the delivery system than ACA (Obamacare). They could very well be right.


I wouldn’t have guessed this is a radiology society’s top priority. It matters to them, but it seems like they’d have bigger fish to fry.


Numbers like this are disturbing. Does it really take that much to be prepared for MACRA? Or do doctors just not understand MACRA and so they answered that they’re not ready? Maybe I was wrong about how many will just take the penalties. Although, it’s still early and I think most will be able to avoid penalties thanks to Pick Your Pace.

Any great tweets or insights you’ve seen about MACRA lately? If so, 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.

MACRA Success Calls For Team Effort – MACRA Mondays

Posted on April 3, 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.

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

A new study suggests that the common-sense approach to handling MACRA issues – getting everyone on your team engaged with issues that arise – is popular among medical practices.

According to Stoltenberg Consulting’s Fifth Annual Health IT Industry Outlook Survey, which polled a mix of IT professionals and executives at HIMSS17, the industry is still struggling to begin their MACRA process. In fact, 64 percent of respondents said that they were unprepared or very unprepared to handle MACRA.

On the other hand, many have a good idea of how they’ll proceed. The survey found that 68 percent of respondents said that practices should bring together clinical, financial and IT staffers when tackling MACRA challenges.

Even so, respondents had some significant concerns about their capabilities. Thirty-one percent of respondents said that revising data management and reporting processes to meet new reporting requirements was their biggest Quality Payment Program challenge. Almost tied was the need to motivate the entire organization to work together towards MACRA goals.

In its commentary, Stoltenberg expands on these themes. “Successful MACRA QPP reporting will take more than just passive submission of claim data,” the report states. “MACRA QPP success requires a defined, focused team which includes IT, clinical and operational departments all led by an executive representative. By combining their expertise, team members can better capture, maintain and analyze data that demonstrates program requirement achievement.”

But creating a team isn’t enough, the consulting firm notes. To move forward, the team must become thoroughly familiar with MACRA QPP and its subtleties. Then, the team will be equipped to evaluate the group’s existing reporting mechanism, decide which reporting gaps exist and figure out how to close them.

Then, the team should create a multi-year roadmap for meeting QPP requirements, including a look at alternative QPP paths they could take and what the impact on reimbursement might be, the report recommends. “A  roadmap will allow a healthcare organization to quickly adapt its MACRA program from year to year, preparing for more stringent requirements in future reporting years or transition from one reporting path to another.”

In addition to addressing MACRA issues, the researchers looked at issues in staffing healthcare IT departments. Fourty-four percent of respondents said that their department wasn’t fully staffed because they lacked the budget to do enough hiring.

Meanwhile, 43 percent said they hadn’t encountered enough qualified, experienced job candidates to fill their open positions. Also, 54 percent said that finding qualified health IT staff and support was difficult, and 28 percent said it was very difficult.

To close these hiring gaps, Stoltenberg recommended that healthcare organizations consider investing in training high-potential IT staffers with less experience, and pair them with advisors who can help them grow their skills.

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

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.