The Centers for Medicare and Medicaid Services took a big step in trying to transform Medicare compensation, debuting the final rule for quality patient care on Oct. 14.
Now, the ball appears to be in the private sector’s court.
The Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, Quality Payment Program aims to transform how Medicare doctors are paid, moving from the Sustainable Growth Rate compensation model to one that focuses on health care solutions.
But part of the formula needed to make MACRA a success will be the efforts underway to encourage the development of electronic health records and technology to streamline reporting.
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“Today’s rule really marks a shift from when government regulations stopped being the defining element of technology roadmaps and customer needs begin to take over,” said Andy Slavitt, acting administrator of CMS, on a conference call.
Slavitt said MACRA’s role as a user-driven policy effort derived from countless interviews with physicians about what they needed to improve both the use of Medicare performance measures, reporting and the technology to manage them.
What they found was a need to simplify reporting required and make it easier to use so doctors can prioritize patient care.
“Overall, I would say in the health care system that we will not be successful if MACRA — or quite frankly any regulation — becomes a complex set of regulations for physicians to learn,” he said.
To make the process simpler, Slavitt pointed to initiatives like a physician portal developed with the U.S. Digital Service, as well as regulatory burden reduction and review, but said that MACRA’s success would also rest on the efforts of private sector as well.
“As we visited physicians around the country, I should share that we learned as much about not just regulatory burden, an equal or greater amount about how technology doesn’t yet support physicians,” he said.
“For physicians to be successful in value-based care requires technology that is easier to use, simpler and more connected, less burdensome and intrusive, that supports the complexity of medicine, but also simplifies by delivering exactly what patients and doctors need when they need it and no more.”
To encourage tech companies to streamline their electronic health records systems, Slavitt said CMS reduced advancing care information requirements by more than half to spur innovation and ease of use.
“We can do our part by lowering the burden, but in many ways, the role of the technology and innovation community is more critical,” he said. “Rather than prescribing innovation, we’re aiming to open up the playing field to make solutions that assist in value-based care easier.”
Part of the tech strategy is the Office of the National Coordinator for Health Information Technology’s efforts at EHR adoption and interoperability, which included today’s rule on EHR certification.
Dr. Vindell Washington, ONC’s national coordinator for health IT, said on the call that health IT would be the bedrock for MACRA’s success, but only with the free flow of EHR information between IT systems.
“Improving the coordination of care between teams of doctors, monitoring the health of a panel of patients or whole communities or identifying those within the community who need the most attention before they show up for care depends on health IT,” he said.
So the advancement of health care remains not a government solution or a private sector one, but a joint effort playing out in real time.
Date: October 14, 2016