With a new look to the U.S. Department of Health and Human Services (HHS), experts hope that Secretary Tom Price, MD, and his team will tackle a number of issues facing physicians. From streamlining regulatory requirements to improving the usability and interoperability of electronic health records (EHRs), this is no small task.
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Eric Fader, JD, a healthcare attorney with Day Pitney in New York, says Price faces “a balancing act” between reducing physicians’ regulatory burden and promoting EHRs as tools to improve care coordination and reduce costs.
The department will have opportunities to work toward those goals as it implements the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the 21st Century Cures Act, which includes numerous provisions related to health information technology (HIT).
Jeffrey Smith, MPP, vice president of public policy at the American Medical Informatics Association, expects the new administration to take both a short- and long-term approach to MACRA.
In the short term, Smith thinks CMS officials may extend the reporting requirements for 2017 into 2018 with few, if any, changes. If HHS officials pursue this strategy, they would give themselves time to think about how they want to implement the program over the long term, Smith adds.
Robert Tennant, MA, director of health information technology policy at the Medical Group Management Association says his organization hopes CMS will allow physicians to comply with MACRA’s reporting requirements in 2018 using EHRs certified to 2014 standards. Current regulations require physicians to upgrade by 2018 to technology that meets 2015 certification requirements.
Tennant points out that few of the 4,000 products with 2014 certification have been recertified under the 2015 standards, making it difficult for physicians to upgrade their EHR systems.
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HHS officials have “quite a bit of leeway” in how they approach reporting requirements for clinicians under MACRA’s Merit-based Incentive Payment System (MIPS), which is designed for physicians practicing medicine primarily in a fee-for-service model.
Under MIPS, clinicians report on four broad categories of performance—quality, clinical practice improvement, cost and “advancing care information” through EHR use. However, HHS officials could implement those performance categories with fewer measures and shorter reporting periods than was envisioned by the Obama administration, Smith says.