By Nathan Stott, Practice Director
We recently broke down the MACRA Transition Year Requirements and briefly touched on each of the four performance categories that will affect physician payments under the Quality Payment Program. One of these categories, Advancing Care Information, is the replacement for Meaningful Use and reflects the largest percentage (25%) of the MIPS composite score for 2017. EHR use is at the core of the Quality Payment Program, with both MIPS and APMs requiring the use of certified EHR technology to qualify for positive Medicare payment adjustments.
Let’s take a look at some of the important details regarding EHR use your practice will need to assess in order to be prepared:
Interoperability & Information Exchange
This point is first on the list for a reason; it is a key component of the MACRA ruling and may also mean changing the system you are using now. MACRA requires that your EHR system be able to transfer patient information to other information systems. This requirement is a direct reflection of the Quality Payment Program’s focus on patient quality of care. Taking a look at how your current EHR communicates with other systems (ease of information transfer, transaction fees, security measures) will be critical in ensuring you are MACRA ready.
Patient Accessibility & Engagement
There are two measures directed at patient involvement: patient access to their medical records, and patient-specific education. Eligible providers must offer the ability to view, download, or transmit health data to their patients. You must also ensure that this data is available to the patient via the device of their choice using an API (application program interface). Additionally, providers are to identify areas of education that may aid patients with chronic disease management, treatment decisions, or other needs, and to offer electronic educational materials to patients.
An additional measure of the Advancing Care Information category is protecting patient privacy through EHR use. This measure requires that practices perform a security risk analysis on a regular basis. Practices must ensure that their EHR can protect the privacy of the patient information with appropriate checks and controls on limiting the access to appropriate individuals, and also provides safe transfer of information.
While many current EHR systems have e-prescribing capabilities, this function is still often underused by physicians. E-prescribing has many benefits to both patient and physician, including convenience, efficiency, and error minimization. Electronic prescribing is a measure that must be reported on so it will be important that your EHR system has the ability and your staff are trained in its use.
Bonus: Public Health and Clinical Data Registry Reporting
While immunization reporting is required for base scoring, any other public health registry reporting can earn your practice bonus points. This can help to maximize your incentives by making up for any lost points or be an addition to your overall score. However, your EHR system must be reporting-ready in order to receive these bonus points.
From an EHR standpoint, it’s clear that MACRA changes not only how physicians’ payments are positively or negatively adjusted, but also requires a complete review, and possible adaptation of a new system. In our next post, we will provide tips for choosing an EHR system that is both MACRA compliant and fits your practice’s needs and current workflow. Stay tuned.