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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Analyzing the Alleged Death of Meaningful Use

Analyzing the Alleged Death of Meaningful Use | EHR and Health IT Consulting | Scoop.it

Earlier this week, Andy Slavitt, Acting Administrator for CMS, told a group of attendees at the J.P. Morgan Annual Health Care Conference that meaningful use is on its way out.


“Now that we effectively have technology into virtually every place care is provided, we are now in the process of ending meaningful use and moving to a new regime culminating with the [Medicare Access and CHIP Reauthorization Act of 2015] (MACRA) implementation,” Slavitt told attendees. “The meaningful use program as it has existed, will now be effectively over and replaced with something better.”


The idea that meaningful use, a program which began in 2011 and aimed to incentivize or penalize physicians for adopting an EHR system, would be over, naturally caused many physicians to celebrate. Melissa Young, an endocrinologist in Freehold, N.J., and a member of the Physicians Practice Editorial Board, e-mailed a three word reaction to the news: “Hooray! ‘Nuff said.”


The AMA had a more formal way of celebrating this news. Of Slavitt, AMA President and CEO, Steven Stack, an emergency physician, told Beckers Hospitals Review in a statement: "He listened to working physicians who said the meaningful use program made them choose between following Byzantine technological requirements and spending more time with their patients. This is a win for patients, physicians and common sense."


In his speech, Slavitt talked about winning the “hearts and minds” of physicians back. Getting rid of meaningful use would undoubtedly help the federal agency achieve that goal, as evidenced by the rising number of docs who opted out of the program due to its stringent requirements.  “The concept of meaningful use was always doomed to failure and it has been proven that there is no improvement in the quality of our healthcare delivery system and it has not reduced the costs of the provision of medical care,” Jeffrey Blank, a podiatric physician in Loxahatchee, Fla., and a member of the Physicians Practice Editorial Board, said via email.


Hold that Thought


Despite the excitement, Robert Tennant, health information technology policy director for the Medical Group Management Association (MGMA), says physicians should keep the champagne on ice. For one thing, they will still be judged on EHR and technical capability.


At the conference, Slavitt talked about MACRA, which authorized the creation of the Merit-Based Incentive Payment System (MIPS). MIPS will measure and compensate physicians on quality, practice improvement, cost, and use of technology. Within MIPS will be elements of meaningful use. Rather than rewarding physicians for using technology, MIPS will aim to pay them on using it towards improving their outcomes.


While Tennant says a reworked meaningful use is “potentially very positive,” the guidelines for MIPS are supposed to be released and finalized this year, which he notes could be a problem for physicians. “Payment under MIPS is supposed to take effect in 2019. If the traditional approach of using a two-year look back [to make those adjustments] is in place, it would mean reporting would begin in 2017,” he says. “If you look at the timing from a regulatory process, we’re concerned with how this would be accomplished.”


In essence, vendors would have to redevelop software around the guidelines, train customers, and practices would have to go live within the space of a year. Moreover, Tennant says if MIPS regulations are finalized in December of this year, they’d likely overlap with a new presidential administration.


“Any new administration, the first thing they do is typically put all pending regulations on hold and review them before they approve,” he says.  Tennant also notes practices still have to be concerned over meaningful use regulations for 2016, including a full-year reporting period and the fact that Stage 3 of meaningful use is technically supposed to be mandatory in 2018.


“We don’t know what we are moving ahead to,” Tennant says. For practices, he advises to select software that fits their clinical needs and to not worry about “arbitrary and potentially changing” regulations. “Don’t focus on 2017 or beyond. We don’t know. The vendor doesn’t know.”


Even still, he is “cautiously optimistic” about Slavitt’s remarks. “We’re hoping CMS takes this opportunity to leverage MACRA to develop a program that is achievable and clinically relevant,” he says.


Blank is interested to see what lies ahead with government regulations, but is not as optimistic as Tennant. “I'm sure that many interest groups and the insurance industry will profit and doctors like me will continue to struggle,” he says.

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Without Obamacare, Jobs Report Might've Been Worse

Without Obamacare, Jobs Report Might've Been Worse | EHR and Health IT Consulting | Scoop.it

The Affordable Care Act, which is infusing millions of new paying customers into the economy who previously couldn’t afford medical care services, continues to boost jobs growth as the health industry emphasizes outpatient care and value-based medicine.


The health care industry added 22,000 jobs last month, which was about on par with February totals for health services jobs, according to the jobs report issued Friday by the U.S. Department of Labor’s Bureau of Labor Statistics.


In the past year alone, 363,000 jobs have been added in the health sector. The entire U.S. economy added 126,000 jobs in March though such totals ended a string of 12 consecutive months when 200,000 jobs or more were added to employment rolls.


The growth in health care continues to come in the ambulatory care sector which is key to the shift away from fee-for-service medicine to value-based care models that emphasize outreach to patients, encouraging them to take their medications and see a primary care provider, typically in a less costly outpatient care setting.


The labor department said there were 19,000 jobs added in the ambulatory care sector. By comparison, hospitals added just 8,000 jobs. And the nursing home sector actually contracted by losing 6,000 jobs.


As an example of the shift going on in health care, technology firms are benefiting as well as hospitals and other traditional medical care providers look to cloud-based platforms to help them manage populations of patients. Value-based care emphasizes health outcomes.


On Friday, Chicago Mayor Rahm Emanuel said health technology company ZirMed, which helps hospitals manage populations of patients in part with predictive analytics and help with claims management, is openings its first Chicago office and would add 200 or more jobs, including “advanced healthcare technologists” to what it calls a “Healthcare Analytics Center of Excellence.”


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