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EHR system, EHR technology, EHRs, Healthcare, HIPAA, Meaningful Use of EHR

The Future of Meaningful Use (MU) of EHR Systems

The Healthcare industry is moving at a fast pace via Healthcare Information Technology (HIT). Everybody knows that electronic healthcare records (EHRs) are the most advanced practice of innovation in the healthcare industry. The meaningful use of EHRs (MU) is not limited to a certain sector of healthcare, which is capable of heavy investment. In fact, it is widely accepted by physicians of every scale and expertise.

Healthcare Chief Information Officers (CIOs) are making sure that their organizations maintain a certain standard of interoperability. Only this way, the actual progression in the industry will be observed.

HIT leaders’ investments in EHRs are not substantial only for today’s use, but they have an eye on the future of meaningful use of EHRs. EHRs are already an advanced form of technology, making patients and physicians empowered.

So what is the Future of Electronic Healthcare Records (EHRs)?

According to the officers of Healthcare IT and the leading EHRs vendors, automation, telemedicine, and advanced analytical tools will have a huge impact on EHR technology.

Impact of Automation and the Advanced Analytical Tools

The automation in the care services in diagnostic, treatment procedures, and in administrative processes has cut down costs. It helps physicians to focus their attention on the work of their expertise, rather than on managerial issues.

The same is the case with Genomics – Informed Medicines which require the genomic information of a patient for his treatment. This approach is quite useful in understanding the diseases’ causes and their impact on patient’s health. This type of medicine also facilitates preventive medicines. Thus, the dimension of reporting of medical records will change drastically.

Telemedicine is the discipline, in which patients and physicians are not present in front of each other. As this technology will strengthen its place in the near future, the way one access, and views EHR will be changed. The virtual delivery of healthcare services has transformed, and this will affect the outcomes of the interoperability measures.

In short, there are different ways to leverage healthcare services. Thus, the devices and algorithms to process or detect illnesses will require a different recording method.

For Example,

How EHR will react towards diagnostic procedures conducted in a home setting, but the test result been given back to the medical organization, especially, when they are to be given to an algorithm or machine as well.

How Increased Interaction Influences Meaningful Use of EHR?

With technology advancement, the virtual diagnosis will move towards increased interaction and user satisfaction. In addition, it will reduce unnecessary cost expenses.

The accommodation of innovation techniques will be difficult to manage as tangible results. Thus, the Meaningful Use of EHR in the future will be helpful in recognizing serious health areas, and it will be using machine learning and predictive models to support the latest technology.

Developing such, intelligent EHRs will be challenging when there is a big issue that is the complexity of the EHR system to handle a large amount of data.

Health IT leaders predict that human-centered designs will resolve this problem. Cloud-based service and aligning work operations to support mobile services will increase the efficiency of electronic healthcare records (EHRs).

With a cloud-based EHR platform, interoperability will also increase via improved security features and the HIPAA-Compliance will be possible to a greater extent.

Mobile-Based EHR Systems

Even today, many professional EHR vendors have developed systems that offer specific functionality of EHRs on smartphones. Everybody knows the accessibility and the scalability of mobile-based systems. By completely incorporating this method into reality, medical records will be at their fingertips and the physicians-patients engagement will be easy.

The main purpose of EHR technology is to support a large population of data without any redundancy. The second purpose is to streamline artificial intelligence to increase a better understanding of healthcare data and remove vulnerabilities in the healthcare system.

Get Ready for the Highest Level of Interoperability via Meaningful Use EHRs

Cloud-based APIs will have a great say in the progressive healthcare system. Smart applications and the additional medical components will form the base of a more secure healthcare system.  The only need is to accept change with open arms.

MIPS and MACRA, EHR technology, healthcare industry, healthcare provider, Healthcare clinical process, Medicare and Medicaid Services, value based healthcare

The Role Of Clinical Quality Measures For Physicians

Since the healthcare industry has taken serious measures to revamp healthcare services, the emphasis on incentive payment programs has increased. MIPS and MACRA, and more offer facilities to physicians that regular payment methods can never provide.

Such incentive payment programs come with various quality measures against which clinical data is needed to report. The number of clinical quality measures is so large that it is difficult to manage them for each healthcare provider. Moreover, the requirements for each program be it Meaningful Use (MU), MIPS, or others, and the implementation of reporting criteria can be quite confusing.

The Center for Medicare and Medicaid Services (CMS) states Clinical Quality Measures (CQMs) for incentive payment programs. The result is not just to pay physicians but the value-based healthcare improvement efforts. These clinical quality measures also put their part in various government or private development projects.

Need of CQMs

Eligible physicians and hospitals submit data to CMS as in MIPS. In return, CMS estimates their performance and reward accordingly while checking that patients are getting the deserved attention from physicians. In addition, it works in favor of the healthcare industry to improve performance categories, falling short in terms of efficiency and quality.

What factors determine success in Clinical Quality Measures Submission?

As per the CMS website, it checks the following parameters to score CQMs.

  1. Use of available resources
  2. Compatibility to healthcare standards
  3. Healthcare outcomes
  4. Patient’s safety and welfare
  5. Coordination among physicians
  6. Patient’s engagement level
  7. Population & overall health standard
  8. Healthcare clinical processes

To maintain the accuracy and transparency in the healthcare system, ONC, Office of the National Coordinator for Health Information Technology (US Government Health and Human Services), monitors the use of EHR and other technologies.

The Development Process of Clinical Quality Measures (CQMs)

MIPS and MACRA, EHR technology, healthcare industry, healthcare provider, Healthcare clinical process, Medicare and Medicaid Services, value based healthcare

National Quality Forum

Many healthcare industry leaders and stakeholders take part in developing CQMs. However, measures standardized by the National Quality Forum (NQF) are considered as the top priority. Most of the incentive payment programs use their measures because their development process involves extensive research.

Another reason for adopting NQF quality measures is their work and objectives that match with that of CMS. Moreover, their initiative boosts the use of electronic healthcare records (EHRs).

Development Process via CMS

CMS also has its own measure development project known as The Measures Management system. This system is always in its evolution stage and sets values for business processes. The deduced measures also support MIPS and other incentive payment programs and provide an opportunity for their growth.

Real-Life Implementation of Quality Measures

Clinical quality measure reporting accounts for many uses, but its major reliance is on EHR technology usage or Meaningful Use. However, many healthcare providers deem Meaningful Use to be stressful and demanding. Moreover, not every quality measure is for everyone. Thus, there should be some flexibility in the reporting criteria.

CMS has gone to great lengths to overcome reporting issues and streamlined measures under seven categories.  When physicians are reimbursed and incentivize, it becomes obligatory for them to maintain their performance instead of giving quality as a one-time shot.

Clinical quality measures are also a great aspect of the Physicians’ Quality Reporting System. Physicians are met with penalties when they don’t report according to the standards.

Thus, MIPS, MACRA, and other payment incentive programs can’t perform their actual functions without efficient marking of clinical quality measures. The key to success is the selection of accurate measures according to the practice and the value-based approach of practicing physicians towards patients.

Looking Back At EHR Meaningful Use From A New Perspective

ARRA – The American Reinvestment & Recovery Act was legalized on February 17th, 2009. It aimed to revolutionize many economic and social sectors including healthcare. Health Information Technology for Economic and Clinical Health (HITECH) Act was also one of its considerations. This act was in great support of the meaningful use of the electronic healthcare records (EHRs), an initiative by the Centers for Medicare and Medicaid (CMS) and the Office of National Coordinator for Health IT (ONC).

Its emphasis on the implementation of EHR technology throughout the USA. Moreover, it is also in accordance with the MIPS quality measure Promoting Interoperability (PI) in which physicians use innovative methods to improve the quality of care services. It requires the use of certified EHR technology to provide a secure exchange of healthcare information.

Plays an Important Role in MIPS Data Submission

The meaningful use of EHR technology also helps physicians to efficiently submit MIPS data to CMS. On the other hand, physicians using this technology can also report measures regarding value-based services to the Secretary of Health & Human Services (HHS) and get incentives.

The Need for Meaningful Use (MU) Act

This act is helpful in generating five possible outcomes for the betterment of the healthcare industry.

  • Improvement in public health
  • Improved coordination in healthcare sectors
  • Increased engagement of physicians and patients
  • Protect patient’s private data from unauthorized use
  • Improved services, safety, and efficiency of the healthcare system

What benefits physicians have for meaningfully using EHR technology?

Meaningful use of EHR

The incentive payment ranges from $44,000 for 5 years to $63,750 for 6 years (Starting from 2011).   Eligible physicians (EPs) and eligible hospitals (EHs) demonstrating adaptation and efficient use of EHR, get valuable rewards. To encourage physicians to go for EHR meaningful use and reduce the burden for healthcare providers, it is classified into three stages.

Stage 1 of Meaningful Use

The requirements of this stage are divided into the 15 core set and 10 menu set objectives. There is an option of choosing 5 out of 10 menu set objectives with the compulsion of at least one population/public health measure.

Stage 2 of Meaningful Use

CMS and ONC have also set standards for the second stage of meaningful use (MU). It released the final rule for incentive programs of Medicare, Medicaid and EHR technology in August 2012.

For this stage, eligible physicians are required to meet for the exclusion to 17 core objectives and 3 out of 6 menu set objectives.

Whereas, it was a must for eligible hospitals and Critical Access Hospitals (CAHs) to qualify for an exclusion to 16 core objectives and 3 out of 6 menu objectives.

Stage 3 of Meaningful Use

In the modified version of stage 2 meaningful use for 2015-2017, clinicians attest to any combination of 2 measures out of 3, while EHs and CAHs attest for any combination of 3 measures out of 4. For stage 3, submitting data for meaningful use was obligatory in 2018.

ONC along with HHS (Department of Human Health & Services) released a final rule in the context of meaningful use and gave certification to the 2015 edition of electronic healthcare records (EHRs). This initiative allowed diverse types of healthcare organizations to get access to healthcare IT.

Thus, medical practices that adopted EHR technology in previous years are now in benefit and can target more incentives, as they have completely understood this method. To get incentives and adopt healthcare IT, physicians should invest their efforts in this system respectively.

HITECH provides high opportunities for healthcare providers to improve their medical practice. The phased approach of three stages allows room for improvement in the public health sector. Moreover, it sets the base of the healthcare system with fewer discrepancies and controls chronic diseases.

For more information, visit, https://www.linkedin.com/company/p3-healthcare-solutions

Highlighted Aspects Of Medicare Usage Of EHR Technology For Hospitals!

The healthcare industry emphasizes on value-based medical services to patients with the correct use of technology and innovation. The purpose is to empower physicians’ RCM and patients with the right to choose quality care services. MIPS is a great addition in this context. It allows physicians to take small steps towards a better healthcare system. However, along with MIPS, the Medicare EHR incentive program also shares the responsibility with the same approach.

Since many hospitals don’t use EHR technology until now. However, the healthcare industry will only progress forward in a secure environment when using the latest technologies. For encouraging physicians and boosting their RCM, The American Recovery and Reinvestment Act of 2009 (ARRA) initiated a program under Medicare. It was to facilitate eligible physicians to use the Certified Electronic Health Record (CEHR) technology meaningfully.

CMS named this program as Medicare Promoting Interoperability (PI) since last year. MIPS also contains this category featuring the benefits of this program, ensuring advancement in healthcare services with the appropriate use of EHRs. This measure appreciates interoperability efforts and applauses for allowing reasonable access of patients to information.

What if Clinicians don’t meet the Promoting Interoperability (PI) criteria!

Healthcare organizations that don’t illustrate the correct depiction of PI will not get payment adjustment for the respective year.
Healthcare, which participates in both incentive programs i.e; Medicare and Medicaid EHR programs can subject to payment adjustments only when it demonstrates the true value in its reporting.

Reporting Criteria for EHR Incentive Program

Prior to 2018, physicians demonstrated EHR use via either CMS Medicare EHR Incentive Programs Attestation System or the state’s attestation system. Now, QNet System confirms the EHR meaningful use and payment adjustments are calculated via a formula specified by the CMS.

What Expectations Should clinicians have for payment adjustments for 2019?

Eligible healthcare organizations, which are not meaningful EHR users, get payment adjustment as a reduction to the applicable percentage proportional to the Inpatient Prospective Program System (IPPS). Thus, it reduces the IPPS standardized amount of healthcare centers.

What are the hardship exceptions?

MIPS and the EHR meaningful uses

Eligible hospitals can avoid negative payment adjustments through hardship exceptions on day-to-day scenarios. Sometimes, CMS itself determines that eligible healthcare falls in an exceptional case.

To apply as an exception, clinicians or hospitals can get information on the official CMS website.

https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html

Given below are the categories for hardship exception cases.

1. New Eligible Healthcare Organizations

Healthcare organizations having new CMS Certification Numbers (CCNs) and insufficient time to submit data can get relaxation for 1 year.

2. Infrastructure Liabilities

Eligible hospitals having no Internet access in their operating area or with insufficient resources to meet the threshold of EHR meaningful use.

3. Unexpected Circumstances

In the case of natural disasters or unforeseen conditions.

4. Vendor Related Issues

Hospitals can apply for this category when they encounter EHR vendor issues to obtain a certification or due to related delays.

What will physicians get in return for their efforts?

  • The foremost purpose is to avoid negative Medicare payment adjustment, and thus revenue cycle management becomes efficient, supporting all the financial matters.
  • The healthcare system improves, and the transparency travels across the board from a higher level to a lower level.

Thus, EHR technology is not just about technology incorporation but a way to fill gaps between patient and physician. Moreover, the advancement in its context helps in successfully submitting clinical data for MIPS as well. Consequently, the healthcare industry flourishes.

Consult the official CMS website for further information https://www.cms.gov EHRIncentivePrograms

Or, visit our LinkedIn page

https://www.linkedin.com/company/p3-healthcare-solutions

Key Points:

  • EHR incentive program
  • The result when not submit data for this program
  • Payment adjustment criteria
  • Hardship exceptional cases
  • Advantages

The Popular FAQs About MIPS – Explained!

Providing value-based healthcare services to patients and having a penalty-less spot in MIPS 2018 requires great effort. However, if strategize properly, physicians can get incentives and bonuses from this program.

Knowing the MIPS program better and accordingly report MIPS quality measures to increase your chances of payment rate from CMS. Therefore, it is always the best to resolve any misconception that might disturb later.

Given below are some of the important FAQs about MIPS that might answer your MIPS queries.

Is saving from penalties in MIPS is not enough?

2018 was the second operational year of MIPS and the minimum threshold for penalties was 15%. This bar is expected to rise in the coming years with strict reporting criteria.

70 MIPS points are the threshold set to get incentives. However, when achieved score higher than that, physicians can qualify for the bonus pool of $500 million. Physicians’ score is displayed on website www.medicare.gov/physiciancompare. The high scorer physicians get an extreme reputation and well-renowned authorities like Medicare, AARP, and CMS endorse them as a brand in the healthcare industry.

Thus, targeting incentives rather than just aiming for a penalty-less spot can open success gateways.

If physicians are still eligible for MIPS, when not using EHR technology?

If you don’t use the 2014 version of EHR technology, physicians may not be able to earn points for Advancing Care Information (ACI), now known as Promoting Interoperability (PI). For maximizing your score, physicians can earn from MIPS quality measures of Quality and Improvement Activities (IA).

Does reporting data for more than 90 days increase the chances of getting a higher MIPS score?

Physicians can choose to report clinical data for 90 days or more for up to 12 months. However, your result is solely based on the performance you showed throughout the performance year.

Thus, choose a report for the period that best suits your requirements and helps to increase the score.

What is the best practice, reporting as a group or an individual clinician?

Both practices benefit clinicians in their own manner so before deciding the best approach, consider the following points.

  • While reporting data to CMS in a group, all physicians will have the same payment rate. However, as an individual clinician, you’ll get your own payment rate. You have to decide which practice will benefit from more revenue generation.
  • Moreover, if any physician has a low-volume threshold, he will not be considered as an individual but as a member of the group.
  • In a multi-specialty group, some providers may find measures that are suitable for their practice, and conversely, they may not be suitable for others’ practice. In such cases, you have to choose measures that suit the single specialty of medical practice.

Is there any exclusion for MIPS?

YES! Physicians are only excluded from the participation of MIPS when,

Medicare allowable is less than $30,000 or less than 100 Medicare patients in 12 months

The healthcare service provider is already a participant of Medicare Advanced APM

Hospital-based healthcare providers are exempted from ACI (MU) category. For them, 25% weight of this category is reassigned to Quality category making its worth to 85% in the final MIPS scorecard

What happens when a physician moves to another medical practice in the payment year?

MIPS score moves with the physician. Even, if you have moved to a new working place, your score will be based on the data reported in the last year, no matter what the medical practice is.

When you work in two different medical practices in the same year, your payment rate under the new TIN (Tax Identification Number) will base on the higher score among both.

What factors should be in mind while selecting MIPS Quality Measures?

MIPS Quality measure and MIPS registry

Choosing the right MIPS measures, according to your practice is a difficult task so research properly about the following points.

There are 250 quality measures and 5 MIPS submission methods and some quality measures are only available for specific reporting methods, so how will you collect data and report to CMS?

Never report for a measure that has less than 20 eligible cases or no benchmark will receive 3 points.

Each reporting method has its own benchmark; thus, determine score by using the correct benchmark. For Example,

The same measure may have less benchmark when reported via a qualified registry as compared to EHR technology.

The above-mentioned points are the most frequently asked questions (FAQs). This article is all about clarifying those misconceptions, which may confuse physicians and block their way of success.

For detailed information about MIPS and its reporting services, visit our LinkedIn page https://www.linkedin.com/company/p3-healthcare-solutions

MIPS&MACRA, MIPS in healthcare, MIPS reporting, MIPS 2019, MIPS quality measures, MIPS qualified registry

MACRA MIPS – Get Ready For These Changes In 2019!

For those covered by Medicare, the paperwork requirements wait for your attention, as a physician, and you can’t take a step back from those duties.

Why has this become crucial for medical practices? Because the Medicare Access and CHIP Reauthorization Act of 2015 and MIPS incentives depend on fulfilling these requirements in the new value-based care system!

And, once you have followed these requirements in letter and spirit, 5% incentives add to your 2020 Medicare payments. Those of you, who don’t think much of this payment adjustment, think again! Because the adjustments increase your finances by huge numbers!

Not all of us are in it for monetary benefits. Nevertheless, the reputational advantage as a clinician will take your practice to the next level. People are going to recognize you as a clinician with superior healthcare knowledge and consider you as an authority in the industry.

To consider MACRA into your practice, upgrade your outdated EHR system to the 2015 certified EHR technology edition. And, consider doing so in case you are an old-fashioned paper-based practice. In addition to that, ensure the technology vendor is trustworthy and has a history of meeting government proposals. A tip to remember here is that proper training of the staff goes hand in hand with the newly installed EHR system.

Prepare yourself for the few changes regarding exemptions under extreme conditions, an increase in the cost category’s weight, an increase in low-volume thresholds, and a boost to the cost performance category in 2019.

Change 1 – Exemptions under Harsh and Uncontainable Situations

Get ready for changes in The MIPS

CMS owns the fact that extreme conditions can affect gathering, storing, and submitting patient information. Hence, in 2019, it gives more space to such clinicians under intense circumstances. According to Clinician Today, in the performance year 2017, the clinicians were not scrutinized for any lack of information if they had to face extreme conditions such as California wildfires.

The automatic exemptions expect to continue going forward in 2019. God forbid, if there are any acts of God or natural disasters, as a MIPS reporting physician, CMS will not put you on a penalty list. First, we pray that neither a flood nor a wildfire breaks around your practice. Second, choose P3 Healthcare Solutions MIPS consulting service for Quality measures and reporting other categories properly 1-844-557-3227.

info@p3care.com is the address you’ll be emailing your queries to.

Change 2 – Expect an Increase in the Weight of the Cost Category

As the Medicare reimbursement model transforms into the value-based care model, MIPS in healthcare will have the cost category hold more weight than in 2018. It was at 10% of the total weight in the previous year and it is going to stay that way or go higher in 2019.

Clinician Today mentions that the cost category is going to accommodate 30 percent of the total MIPS score (CPS) by the year 2022. By preparing early and maximizing on this category, your practice can achieve a decent MIPS final score. Consequently, everything falls in line with quality-based care.

To maintain the balance between categories, expect a formidable decrease in the weight of the Quality category at an equal level.

Change 3 – Expansion in Low-Volume Thresholds (LVT)

A Low-Volume Threshold (LVT) depends on the number of allowed Medicare Part B charges and the number of patients cared for by an eligible clinician. There is a consistent increase in the LVT in subsequent years until 2018. And, 2019 is not going to be any different.

Currently, the LVT has more than or equal to 200 Medicare patients or your practice/group has billed more than or equal to $90,000 in Medicare Part B allowed charges. It was an uptick to MIPS 2017 requirements of 100 Medicare Part B patients or $30,000 Medicare Part B allowed charges.

You may not be eligible in the past year, but there is a high probability of your eligibility for MIPS submissions in 2019. Therefore, be well aware, and as soon as you reach the Low-Volume Threshold, P3Care being a MIPS qualified registry, reports on your behalf so that you receive high incentives.

Change 4 – MIPS Cost Category to Experience a Boost

We can see the cost category weight rise to 15% in 2019. MIPS 2019 reporting is not going to be a child’s play because the focus on trimming healthcare expenses is now more than before. CMS suggests adjusting this raise by offsetting the Quality category from 50 to 45%.

Hence, be on the lookout for any changes in government regulations around Medicare reimbursements! Quality reporting aims to improve healthcare delivery and better compensation to physicians.

We try to give you insight into the world of medicine as it crosses paths with medical billing. P3 Healthcare Solutions deals with the revenue cycle management process efficiently when it comes to MIPS consulting and medical billing service in general. One remedy to stay updated with the latest Medicare MIPS reporting requirements and to provide quality billing services to clinicians.