This week I testified before the United States House of Representatives. It was an honor to represent the healthcare IT industry and share how innovations are driving efficiencies and improvements. Here are excerpts from that testimony: Despite some bumps in the road, as can be expected in times of change, there have been huge leaps forward in our industry in recent years that never would have happened had Congress not provided the impetus for ubiquitous adoption of electronic health records (EHRs). These changes have disrupted paper systems that stood for decades, and the result is a new digital ecosystem of caregivers, software developers and patients, allowing all to take a fresh look at how processes can be enhanced via automation. Fortunately, following disruption, there is innovation and opportunity. Allow me to provide a few examples: Allscripts dbMotion™ interoperability platform brings […]

Last week The Centers for Medicare and Medicaid (CMS) Acting Administrator Andy Slavitt issued an official blog post announcing proposed reporting options for the Quality Payment Program (QPP), the program stemming from the Medicare Access and CHIP Reauthorization Act (MACRA), for program year 2017. The intent of these options is to give participants more flexibility during the initial year of this significant program. For 2017, the blog post identifies four options: 1) Submit “test” data to CMS for any period of time within 2017. Choosing this option will eliminate any penalties from the MIPS program. 2) Submit complete data for a portion of program year 2017. Choosing this option will provide the opportunity for a partial incentive payment, if any is earned. 3) Submit complete data for all of program year 2017. Choosing this option provides the opportunity for a […]

2 comments

A beginner’s guide to MACRA

MACRA is perhaps the most significant piece of proposed healthcare regulation I’ve ever seen. We’ve had a series of webinars to help clients understand the key points, and distilled them here in a Q&A format. What is MACRA? MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. It is Medicare payment reform designed to help lower the cost of health care, while delivering better quality and improving health outcomes. It creates a more comprehensive value-based framework for payment and combines different quality-based measures into one system. Is MACRA final? No. MACRA was enacted in April 2015, but a public comment period has been open from April through June 27, 2016. The government is estimating the final rule will be available in October 2016. If it’s not final, why should I worry about this now? MACRA includes many changes, […]

The Medicare Access and CHiP Reauthorization Act (MACRA) was signed into law by President Obama in April 2015 with overwhelming bi-partisan support. The bill includes many changes, and arguably the most critical impact is the introduction of a new payment model that will affect all providers starting with the 2019 payment year. Unfortunately, many in the healthcare industry have a false sense of security: while 2019 is the official start date for the new payment models, 2017 will be the performance year that determines 2019 payment adjustments. Be ready for MACRA by Jan. 1, 2017 By the end of 2016, organizations and providers must understand the impact of the MACRA changes, develop their strategies for success in the new model, and implement changes necessary to support their strategies. Organizations must start taking action now. CMS will publish the proposed rule […]

On November 16, the Centers for Medicare & Medicaid (CMS) published the Comprehensive Care for Joint Replacement (CJR)* final rule, marking a significant milestone in the advancement toward value-based care. “Today, we are embarking on one of the most important steps we will take to improve the quality and value of care for hundreds of thousands of Americans who have hip and knee replacements through Medicare every year,” said Sylvia Burwell, secretary of Health and Human Services. CJR will test whether or not bundled payments to hospitals for lower extremity joint replacement (LEJR) surgery episodes will reduce Medicare expenditures and enhance the quality of care for beneficiaries.  Due to the high number of public comments, the rule has expanded from about 400 pages to more than 1000. What changed from the proposed rule to the final rule Our preliminary observations […]

The Health Care Payment and Learning Action Network (HCPLAN) recently held its first summit in Washington, D.C.  I joined about 250 healthcare industry leaders at this event, which demonstrated that this group will play a significant role in shaping health care’s transition from fee-for-service to value-based-care models. The U.S. Department of Health and Human Services (HHS) created the HCPLAN earlier this year towards the goal of moving 30% of Medicare reimbursements to alternative payment models in 2016 and 50% by 2018. Through the HCPLAN, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. Two of the main topics at the summit were the Alternative Payment Model (APM) Framework and Medicare Access and Chip Re-authorization Act (MACRA). Here’s a summary of key points in each […]

Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the third in a three-part series that will address aspects of interoperability: 1) overcoming barriers 2) financial motivation and standards, and 3) information blocking. An important consideration for information liquidity are the physician practices (small and large) and independent hospitals that have been pressured to move off of their current Electronic Health Record (EHR) system – Allscripts in some cases – to one used by the large enterprise health system in their area. It’s called “data bullying” or “information blocking,” because one party isn’t committed to establishing connectivity between current systems and in some instances, will even put up indirect roadblocks. For example, sometimes larger health systems […]

Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the second in a three-part series that will address aspects of interoperability: 1) overcoming barriers 2) financial motivation and standards, and 3) information blocking. The current payment system simply does not offer appropriate financial motivation for providers to create an interoperable healthcare environment; this is especially true given that the burden of cost falls to them almost exclusively. Healthcare providers are genuinely committed to providing the best care they can to patients, but the common reality of running on only a few days’ cash flow sometimes trumps loftier goals. Much as CMS policy has already had a marked impact on hospital readmission rates by associating them with […]

Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the first in a three-part series that will address aspects of interoperability: 1) overcoming barriers, 2) financial motivation and standards, and 3) information blocking. Interoperability is of great concern to us, as more independent doctors use our software to treat patients than any other commercially available product. If a stakeholder were to intentionally get in the way of information exchange, there are two main concerns: 1) it would be bad for patients, and 2) it could be anti-competitive. Period. Several years ago, Allscripts made a decision to invest in an Open approach to connectivity – one that is grounded in the Allscripts dbMotionTM Solution connectivity platform and […]

2 comments

ICD-10: Tips for heading into the home stretch

Hospitals and physician practices have been discussing ICD-10 for many years. However, even with a one-year implementation delay, many of them are only now realizing that they are still not ready for the October 1 start date. In the past month, our ICD-10 consulting practice has received more inquiries for assistance than in the past calendar quarter. We expect this pace will continue well into the coming months leading up to October. A significant number of inquiries have come from organizations that have considered ICD-10 to be an IT or HIM issue. In fact, when looking at the scope within a hospital or practice that ICD-10 encompasses, there are more than a dozen areas that should be involved, such as revenue cycle and contingency planning. Ignoring any of these areas can have a detrimental effect on ICD-10 readiness. 3 most […]