After many months of debate and years of more broadly discussing some of the related concepts, the 21st Century Cures Act (H.R. 34) passed the House and Senate last week, and was signed by the President today. It is a massive piece of legislation, 996 pages in length, and it will have a tremendous impact on medical innovation across the health sector. The law’s primary objectives are to speed new medicines to market through a wide-ranging number of adjustments to the FDA’s work, the clinical trial process and the work of the National Institutes of Health (NIH). But the legislation also includes several important sections that address health IT, including the bulk of the Title IV – Delivery section, which recognizes that delivery reforms are reliant on health IT to move forward. While there are elements of the new law […]

Editor’s note: MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015, and is Medicare payment reform that goes into effect Jan. 1, 2017. The associated Quality Payment Program (QPP) is the regulation that will shift the reimbursement model from volume-based payments to a more comprehensive value-based framework. In this MACRA 101 blog series, Jim Brulé dives into the details of the two tracks within the QPP, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). Participants that choose the optional APM track are agreeing to higher risk but also have the potential for higher potential reward than their counterparts in the default MIPS track. The APM track relies on a category of risk-based payment models with shared characteristics. These models require Certified Electronic Health Record Technology (CEHRT), use quality measures similar to MIPS and […]

The shift to value-based care has caused a number of mergers, acquisitions and strategic partnerships, prompting experts to call 2016 the year of “merger mania” in health care. While these strategies offer benefits and economies of scale, they also introduce new challenges when it comes to integrating clinical data. Allscripts interviewed industry leaders about the interoperability challenges they face as healthcare organizations align, and how they are forging ahead with quality care, population health and analytics initiatives. Here are five tips from the experts on how to position for success in a value-based world: 1. Recognize the cultural aspects of change “Right now, we’re in an environment that has nine different electronic health records and 14 different practice management systems across all practices. We’ve tried for years to get the right level of interoperability in place. But it’s a significant […]

Editor’s note: MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015, and is Medicare payment reform that goes into effect Jan. 1, 2017. The associated Quality Payment Program (QPP) is the regulation that will shift the reimbursement model from straight fee for service to a more comprehensive value-based framework. In this MACRA 101 blog series, Jim Brulé dives into the details of the two tracks within the QPP, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). The Centers for Medicaid and Medicare (CMS) estimates that of the 712,000 Medicare Eligible Clinicians (ECs) that will participate in the QPP, about 87% will default to the MIPS track in the initial years. It has lower risk but also lower incentives, as it was crafted by Congress to ultimately be the less attractive option. Calculating […]

Editor’s Note: This blog post first appeared on The Standard, The Official Blog of Health Level Seven® International. You can view the original post here. Most people have heard of HL7 Fast Healthcare Interoperability Resources (FHIR®) Connectathon events, as well as IHE North America and European Connectathon events, which focus on testing the interoperability of solutions. But did you know that one of the most important content efforts – improving C-CDA® (Consolidated Clinical Document Architecture) documents – is also underway? At each HL7 C-CDA® Implementation-A-Thon, health IT activists have met to improve C-CDA quality and resolve industry differences that result from varying interpretations of standards and implementation guides. Efforts to improve the content of the C-CDA Many efforts are underway across the industry to help all of us improve the content of C-CDA documents. For example, the Relevant and Pertinent project […]

MACRA, which stands for the Medicare Access and CHIP Reauthorization Act of 2015, was legislation that reformed the Medicare payment system to help lower the cost of health care, while delivering better quality and improving health outcomes. It represents a huge change – it creates a more comprehensive value-based framework for payment and combines different quality-based measures into one system. In October, the Center for Medicare and Medicaid Services (CMS) issued the final rule for the new Quality Payment Program (QPP) following direction from the MACRA, and it goes into effect Jan. 1, 2017. As we get closer to this regulatory program, here are some key points to consider: While 2017 is a transition year, Medicare Eligible Clinicians (ECs) must take action to avoid a penalty. CMS anticipates that more than 700,000 Medicare ECs will participate in the QPP. ECs […]

Following every election cycle, the United States experiences a change in policy and direction. During his campaign, Donald Trump said little about his plans for health IT, precision medicine or delivery system reform, so it will take some time for us to have a real sense of his administration’s thoughts on these subjects. Since his election, I’ve already had many conversations with healthcare policy experts. Insights from these discussions include: 1) Interoperability – Continues to be a priority Congress remains interested in monitoring success with healthcare interoperability and the possibility of legislative action, including attention to further standards development.  Congress will also be paying close attention to the implementation of the MACRA, gauging whether it is successfully driving the adjusted behavior from clinicians that they are seeking. 2) MACRA – Adjustments may take place, but the core program will remain consistent […]

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Advancing patient-centered practice transformation

  • Dr. Ramanujam (Ram) Venugopalan, BHMS, MHA, PCMH CCE, PGDMLS
  • 11/07/2016

Healthcare market dynamics are shifting toward value-based care. For primary care practices seeking patient-centered care and the associated financial incentives, the Patient-Centered Medical Home (PCMH) model is the sweet spot. As sweeping delivery system reform kicks off in 2017, practices can look forward to a clear regulatory roadmap to align their efforts with the PCMH model and succeed in their journey to becoming truly patient centered. Increasing focus on patient-centered care Early attempts to define the framework for PCMH date back to the 1960s, with the goal of offering patient-centered, family-oriented and family-coordinated care delivery to families. Years of experience related to success of this model has led to the formation of many recognition programs. Today’s National Committee for Quality Assurance (NCQA) PCMH program is a widely known offering to recognize practices demonstrating patient centeredness. As of July 2015, NCQA […]

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6 questions to ask about EHR rating methodologies

According to research, which electronic health record (EHR) vendor is ranked number one? It may seem like a simple question, but if you’ve tried to answer it, you’ve likely found a wide range of responses. Analyst firms, researchers, industry associations and vendors all take on different perspectives when they rank EHR platforms. It’s important to know your sources and understand their market definitions and methodologies before you weigh these results in your next EHR purchasing decision. Like a good old-fashioned reporter, you should know the “Who, What, When, Where, Why and How” behind these findings. More specifically, here are questions to help you evaluate the next EHR rating that crosses your inbox: Who? Firms like Gartner and IDC take a more traditional analyst-derived opinion perspective. Other firms, like Black Book and KLAS Research, rank vendors based on survey data collected […]

As the industry recognizes the potential of genomic information to revolutionize healthcare delivery, experts describe the many challenges and opportunities related to precision medicine. A recent Health Data Management article, WEDI: EHR support for genomic medicine lacking, reviews highlights of a white paper from the Workgroup for Electronic Data Interchange (WEDI) Genomics Workgroup. Because our team has years of experience in embedding clinical knowledge in the clinical workflow, and since we are working toward making precision medicine possible at the point of care through our genomic platform 2bPrecise, I wanted to share a few thoughts and reactions here: 1) EHRs don’t lend enough support to genomic medicine Authors of the white paper contend, “Although improvements to electronic health records (EHRs) have been made, much work remains to optimize their ability to support genomically informed care, and in turn, for genomic […]