From the May 2016 issue of HealthCare Business News magazine
Through the Medicare Access and CHIP Reauthorization Act of 2015, the incentive- laden Meaningful Use program will shift to also include the standardization of data use and interoperability, which enables patient data to be shared with other physicians and government organizations.
By measuring physicians’ compliance and benchmarking them against other providers, the next iteration of Meaningful Use, which will be rolled into the Merit- Based Incentive Payment System, will usher in a new era of health care that will have a significant impact on the industry.
Originally, Meaningful Use was established through the Health Information Technology for Economic and Clinical Health Act in 2009 to authorize incentive payments to health care providers who use certified electronic health record systems. With the ambitious intent of reducing costs and improving care, Meaningful Use was defined as using technology in a “meaningful manner” to ensure the electronic exchange of health information. While many small- to mid-sized providers are still struggling to efficiently and effectively migrate to an EHR system, many also collected government incentives. Now, MIPS will give doctors a quality score to determine a Medicare reimbursement.
The MIPS program will also include the Physician Quality Reporting System, which is the quality reporting program that has rewarded providers for participation and meeting certain requirements. With MIPS, the data collected will also highlight each provider’s quality of care, based on typical measurements, such as length of stay and re-admittance, and also evaluate those numbers based on the total cost of care. EHR technology has eased the PQRS burden by allowing necessary information to be gathered more easily. Reporting information electronically is also more efficient than paper claims, which can be an administrative nightmare.
MIPS will likely have major consequences for health care providers, because in the new era of health care following Meaningful Use, there will be winners and losers. Providers who meet the set criteria will receive reimbursements, but practices can also be penalized for not achieving key performance metrics. At least three major impacts on the industry can be expected.
1. Remaining compliant will require a significant commitment. Not only can initially implementing technology be a drain on the balance sheet, but with ever-evolving requirements, it will take significant time to properly document compliance. Taking time away from patient care to constantly train and ensure the staff is properly documenting the necessary metrics will be difficult — especially for the smaller providers.