As your practice embraces Medicare payment reform, make sure your technology is ready as well.
When playing chess, the goal is to achieve checkmate. To do that requires a savvy strategy, the same kind needed to find success under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
And it also requires the right tools, including a practice’s electronic health record (EHR) system.
FURTHER READING: Are you ready for MACRA? Scorecards can help
Tina Colangelo, a MACRA readiness expert in New York City, recommends asking vendors the following 10 questions so physicians are fully prepared for the Merit-based Incentive Payment System (MIPS).
1. Are you doing what you're supposed to do for my practice?
Embrace the EHR as you embrace MACRA, and use it as a learning tool instead of dreading every time using it. Hold the vendor accountable, because the practice probably invested thousands of dollars. The vendor also probably charges to upgrade, so ask about anything regarded to MACRA that requires an additional fee.
2. Did you conduct a security risk analysis in 2017?
Every vendor should do that, says Colangelo. Practices are charged with protecting patients' information under HIPAA. The information is in the hands of the EHR system, and ultimately, the vendor. If a security risk analysis isn't done, practices will lose either 25% of its overall MIPS points or all points in the advancing care information (ACI) category.
3. What MIPS measures can you report to CMS?
Make sure the measures the practice wants to report can be handled by the EHR vendor. That could be a problem if, a gastroenterologist for example, purchased a system that only submits primary care measures.
IN CASE YOU MISSED IT: 10 things physicians need to know about MACRA in 2018
4. What functionality is available to track the measures?
Physicians want reassurance their EHR monitors those measures and that all the data around them is complete. Ask the vendor what specific tools the EHR has to track measures and monitor performance. For example, does it print a weekly report or a bi-weekly report?
5. How does the EHR help my practice target measures and key performance indicators?
First, ask whether the system offers the use of templates or dashboards. Then ask, "How does it help my practice submit MIPS measures?"
Next: Questions 6-10
6. Will I pay an additional fee to have dashboards?
Practices likely don't want an extra fee here and an extra fee there. Try negotiating these with the vendor.
EDITORIAL: CMS should exempt all-not just some-small practices from MACRA
7. Will I pay extra to upgrade the 2015 certification?
This year and next, practices are fine using the 2014 EHR certification with MIPS. Physicians can receive up to 10 bonus points in the ACI category if they upgrade to the recently-released 2015 certification. Ask the vendor for a discount for upgrading early; meaning now.
8. Can the system generate performance reports that reveal how well a practice performs in certain areas?
Clinicians will need continuous performance monitoring to be successful. Ask the EHR vendor to help with this.
Physicians may not always want to, but it's important to track performance points to know how they are doing. Think about it like taxes: Don't wait until the end of the year to assess what might be owed.
Maybe the practice has chosen blood pressure, for example, but patients eligible to meet that measure just aren't coming in. The performance report will document that, so it won't submit blood pressure as a metric and perhaps submit tobacco use instead. It all goes back to strategy.
9. Does your EHR allow the practice to send secure messages to all patients through the patient portal?
The answer should be "yes" because patient engagement and satisfaction comprise the core of MACRA. Patients don't want to work so hard, so give them easy access to reports, results and advice on the patient portal. Physicians will also earn extra points on improvement activities.
10. Can I count on you to be my backbone?
This is the most comprehensive change to affect healthcare in 50 years. Practices and their vendor need each other, so ensure they will be there to support the efforts every step of the way.