- As the Centers of Medicare and Medicaid Services (CMS) draws the curtains on meaningful use, healthcare providers are wondering how the proposed Advancing Care Information program would replace EHR Incentive Programs in 2017.
In a recent fact sheet, CMS details the Advancing Care Information program and how it could be used to assess value-based care for office-based physicians and other clinicians in the Merit-Based Incentive Payment System (MIPS).
Under the notice of proposed rulemaking for MACRA implementation, the Advancing Care Information program would replace meaningful use in efforts to realign Medicare payments with patient-centered, quality care. It is designed to provide more flexibility for physicians when it comes to reporting quality care and certified EHR use.
“The proposal for Advancing Care Information is designed to simplify requirements, support patient care, and be flexible to meet the needs of physician practices,” stated the fact sheet. “The proposal emphasizes measures that support improved patient engagement and connectivity and reduces reporting burden.”
CMS reported that there are four major differences between Medicare EHR Incentive Programs and its potential replacement.
• For EHR Incentive Programs, healthcare providers were required to report on all objectives and measure requirements. CMS noted that it reduced the number of clinical quality measures in the Advancing Care Information program and the new measures will stress interoperability, HIE, and security measures. Clinical decision support and computerized provider order entry measures are no longer mandatory, CMS pointed out.
• In the Advancing Care Information program, eligible healthcare providers would be able to select which clinical quality measures are most relevant to their practice. CMS reported that this is a significant difference from the “one-size-fits-all” methodology of meaningful use, which required providers to report on every measure and every measure was weighed equally.
• CMS also designed the proposed program to provide more flexibility in terms of certified EHR use and quality reporting. Previously, healthcare providers were evaluated on an “all-or-nothing” basis.
• The Advancing Care Information system would also coordinate with other Medicare reporting programs, explained CMS. EHR Incentive programs did not align with other reporting programs, which created substantial administrative burden on physicians.
Additionally, the scoring methodology for measuring certified EHR use and value-based care would change under MACRA. Healthcare providers in MIPS would be assessed for quality, resource use, and their success in Advancing Care Information and Clinical Practice Improvement Activity programs.
“Initially, the Advancing Care Information category would account for 25 percent of the MIPS score,” stated the fact sheet. “For this category, physicians and other clinicians must use certified EHR technology and could choose to report a customizable set of measures that reflects how they use EHR technology in their day-to-day practice, with a particular emphasis on interoperability and information exchange.”
CMS elaborated that healthcare providers can receive 100 or more points in the Advancing Care Information category of the MIPS Composite Score. By earning 100 or more points in this section, providers would receive the full 25 points for the program, which will be factored into the MIPS score.
According to the fact sheet, healthcare providers can earn a base score of up to 50 points in the program category based on reporting six objectives and their measures. Healthcare providers would be required to measure patient health information protection, electronic prescribing, patient electronic access, care coordination through patient engagement, HIE, and reporting to public health and clinical data registries.
Healthcare providers could also earn up to 80 points on a performance score. In this section, physicians would be able to choose the measures to report, including patient electronic access, care coordination through patient engagement, and HIE.
Additionally, physicians could earn an additional point by reporting to different public health registries other than the required immunization registry, CMS pointed out.
In the fact sheet, CMS noted that the MIPS composite score may be adjusted to eliminate the Advancing Care Information portion if the measures are not applicable to certain healthcare providers.
Through the proposed scoring techniques, CMS intends to provide healthcare providers with more comprehensive and flexible options for quality and certified EHR use reporting. Rather than just reporting to meaningful use, the agency aims to transform how providers view value-based care program.
“These improvements should increase providers’ ability to use technology in ways that are more relevant to their needs and the needs of their patients,” wrote Andy Slavitt, CMS Acting Administrator, in an official blog post about the proposed rulemaking on MACRA. “Previously established requirements for APIs in the newly certified technology will open up the physician desktop to allow apps, analytic tools, and medical devices to plug and play. Through this new direction, we look forward to developers and entrepreneurs taking the opportunity to design around the everyday needs of users, rather than designing a one-size-fits-all approach.”
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