I’ve been writing fewer posts recently because the trajectory forward for healthcare and healthcare IT seems to be evolving very rapidly. In just the past week, we’ve had: the American Hospital Association letter suggesting that 21,000 pages of regulations be rolled back including Meaningful Use Stage Three concepts and quality measurement in many care settings, the passage of the 21st Century Cures bill and its many IT related mandates, and the nomination of Tom Price for HHS Secretary and Seema Verma for CMS administrator...
Merit-based Incentive Payment System (MIPS)
See the following -
Modernizing Medicine Unveils Population Health Platform and Apple Watch Application at Annual User Conference
Press Release |
Modernizing Medicine |
November 30, 2016
Specialty-specific health information technology company Modernizing Medicine, Inc. announced major technological advancements to its intuitive suite of products and services at the company’s third annual user conference, MOMENTUM. An enhancement to the company’s specialty-specific electronic health record (EHR) system, EMA, and Practice Management system, Analytics is designed to give physicians near real-time population health data to help support the transition to value-based healthcare...
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21st Century Cures and the Road Ahead
By John D. Halamka, MD | December 7, 2016
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An Alternative Proposal for Certification
By John D. Halamka, MD | July 6, 2016
Some have suggested that my comments over the past few months about the Meaningful Use program, MACRA/MIPS, and Certification imply that we should just give up - throw out the baby with the bath water. That’s not what I’ve written.
Here’s a clarification. I believe MACRA/MIPS is the right trajectory - create a set of desirable policy outcomes, then enable clinicians to choose technology, quality measures, and process improvements that are relevant to their practice...
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Black Book Research Warns Gov. Regs and Lousy EHRs are Driving Independent Medical Practices into Extinction
Press Release |
Black Book Market Research |
June 13, 2016
Two-thirds of independent practices now deliberately selling out to hospital systems and larger groups or closing down by 2019 as the resource-intensive requirements of MIPS, administrative burdens, and under-optimized technology may make the transition to value-based care too discouraging...Despite small practice education, training and technical assistance programs promised from CMS to help onboard physicians with the MACRA programs, 89% of the remaining solo practices expect to minimize Medicare volumes as to not be required to submit reports for the quality and clinical practice improvement activities or report in the cost performance category.
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Ensuring Physician EHR Use Doesn’t Lead to Physician Burnout
Kyle Murphy | EHR Intelligence | March 28, 2016
With the entire healthcare industry undergoing tremendous amounts of change — from how care is coordinated and delivered to how providers are reimbursed for that care — there are likely to be side effects. One the head of the American Medical Association (AMA) is targeting is the matter of physician burnout tied to providers having to balance the day-to-day realities of patient care with federal and state mandates regulating aspects of that care such physician EHR use and clinical quality reporting...
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Halamka Pays a Visit to Oscar Health
By John D. Halamka, MD | August 10, 2016
Today I’m in New York City visiting Oscar Health, on my continuing quest to determine how best to integrate digital platforms, patient-family engagement, and care coordination in preparation for MACRA/MIPS and the transformation from fee for service to alternative payment models. At the moment, there is no single magic bullet, but there are early innovations that hold promise. At BIDMC we’ve thought the best approach to care management is to identify a cohort with a disease, then enroll that cohort in a program which involves tracking progress against guidelines/protocols, deploying telemedicine/visiting nurses, and measuring data from home-based devices...
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Halamka Summarizes the CMS Meaningful Use Final Rule
By John D. Halamka, MD | October 20, 2015
I’ve been asked to summarize the 752 page CMS Meaningful Use Final Rule...Between the Notice of Proposed Rulemaking and the publication of the CMS Final Rule, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed to include sunsetting the Meaningful Use payment adjustment for professionals at the end of 2018. Also, MACRA requires the establishment of a Merit-Based Incentive Payment System (MIPS) which would incorporate Meaningful Use. The comment period will be used in an attempt to align the Meaningful Use program and the MIPS program...Stage 3 is more controversial and I will focus on that.
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Halamka's Reflections on US Health IT Policy Trajectory
By John D. Halamka, MD | July 6, 2017
I’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai, and Suzhou. The twelve hour time difference means that I can work a day in China, followed by a day in Boston. For the next 7 days, I’ll truly be living on both sides of the planet. I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days. I’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance for implementation of MACRA/MIPS, but here’s the excellent 26 page synopsis created by CMS which provides an overview of the 1058 page rule...
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Healthcare Technology Costs Top $32,500 per Physician
Press Release |
Medical Group Management Association |
August 10, 2016
As they move to digitize their practices and patient medical records, healthcare organizations across the country continue to grapple with significant increases in information technology costs. According to new data from Medical Group Management Association, physician-owned multispecialty practices spent more than $32,500 per full-time physician on information technology equipment, staff, maintenance, and other related expenses in 2015...
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How Does FHIR Fit into Recent Interoperability Initiatives?
Sara Heath | Health IT Interoperability | May 18, 2016
Over the past few months, APIs have been the talk of the healthcare industry, pushing HL7's FHIR into the spotlight for interoperability. Plenty of talk supports the position that application programming interfaces (APIs) will enhance health data interoperability, particularly a leading API standard known as FHIR. Health Level 7’s Fast Healthcare Interoperability Resource (FHIR) is a data standard that helps different health applications work on the different interfaces that exist in the industry (such as an Epic Systems or a Cerner interface)...
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Increasing Health IT, EHR Investment Runs Up Practice Costs
Sara Heath | EHR Intelligence | August 10, 2016
New data from MGMA shows that increasing health IT and EHR investments are running up major practice costs. Health IT and EHR investments are costing physician-owned multispecialty practices thousands of dollars per physician, according to a new report from the Medical Group Management Association (MGMA). The 2016 MGMA Cost and Revenue Report shows that health technologies such as EHRs ran physician practices up to $32,500 per physician in 2015...
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MACRA: Big Fix or Big Problem?
J. Michael McWilliams, MD, PhD | Annals of Internal Medicine | May 16, 2017
In January 2017, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) took effect, ushering in a new system for physician payment in Medicare. With MACRA, policymakers ended the Sustainable Growth Rate (SGR) method for updating physician fees in Medicare and provided a permanent “doc fix,” relieving Congress of its annual duty to override substantial fee cuts that the SGR would have imposed. In place of the SGR, MACRA instituted the Merit-based Incentive Payment System (MIPS), which intends to reward clinicians for providing higher-quality and lower-cost care...
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Making Sense of MACRA: A Glossary of New Medicare Terms
Press Release |
American Medical Association |
December 5, 2016
As John Harvey, MD, FACS, past president of the Medical Association of Georgia, has toured his state to discuss the upcoming Medicare payment transition, he has noticed a trend. “More than half the physicians I have talked to … were not aware of the terms MACRA, MIPS and APMs.” Of course, there are also QPP, ACI and numerous non-initialisms that refer to crucial elements of the law that repeals the sustainable growth rate. Following is a short list of the terms every physician should know before the new payment rules take effect Jan. 1...
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Number of Public HIEs Drop, Bringing Viability into Question
Greg Slabodkin | Health Data Management | July 8, 2016
Despite federal funding that aided their creation, the number of community and state health information exchanges is declining as HIEs struggle to remain financially viable now that seed money has dried up. Those are among the results of a new national survey published in the July issue of Health Affairs that tracked community and state HIE efforts soon after federal funding ended. “We found 106 operational HIE efforts that, as a group, engaged more than one-third of all U.S. providers in 2014,” states the study’s authors...
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ONC Head Dr. Donald Rucker Addresses open API's, Interoperability and Usability During WEDI Keynote
Press Release |
Workgroup for Electronic Data Interchange (WEDI) |
August 23, 2017
Earlier this month, the Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange and a trusted advisor to the U.S. Department of Health and Human Services (HHS), held its 2017 Summer Forum which featured keynote addresses by Donald W. Rucker, MD, head of the Office of the National Coordinator for Health Information Technology (ONC/HHS) and Madhu Annadata, director, Division of National Standards, Centers for Medicare & Medicaid Services (CMS)...
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