IT Forefront

Medicare just dropped 1,000s of pages of regulations. Here's what IT leaders should know.

by Ye Hoffman, Julia Connell, and Camille Bridger

CMS recently released several thousand pages of annual rulemaking. These regulatory updates establish next year's Medicare payment policies and reporting requirements across various programs. Affected providers must successfully participate in these programs to avoid hefty penalties and/or potentially earn incentives.

What do these regulatory updates mean for IT leaders? Notably, the Promoting Interoperability (PI) Program and the Quality Payment Program (QPP) both require providers to use health IT in a "meaningful" way. Providers must report performance data for measures that rely on certified EHR technology (CEHRT). Because IT leaders are responsible for supporting these systems, it is critical to stay up-to-date on the changes to reporting requirements.

 Here are three ways IT leaders can help providers succeed in these programs year-over-year:

1. Partner with clinical and operational leaders

Once new technical capabilities are implemented in CEHRT, there is often significant work ahead before providers can successfully meet CMS requirements. For example, it is not sufficient to simply enable the technical Application Programming Interface (API) capability, providers must also educate patients on how they can connect apps to the API. This means IT leaders must work closely with their clinical and operational counterparts to establish appropriate policies and practices in order to comply with CMS requirements. Join our webconference on September 5th at 3 p.m. ET for guidance on the most challenging hospital PI measures, and to learn more about the program requirements finalized for 2020.

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2. Focus on EHR optimization

For the most part, the recent CMS rulemaking offers a period of relative stability in 2020 compared to previous years of program overhauls and new CEHRT requirements. For example, there are only minor changes finalized for the hospital PI program in 2020, and the few updates primarily affect optional measures. This affords IT leaders the opportunity to shift gears away from merely keeping pace with EHR upgrades and focus on system optimization. Over time, EHR usability concerns have contributed to clinician burnout, which has a clear link to care quality, patient safety, and clinician health and well-being. View our on-demand webconference on EHR optimization to learn about the top concerns and how to reduce burnout through EHR and clinical decision support optimization.

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3. Anticipate significant future regulatory changes

It appears that 2020 may be a "calm before the storm" for regulatory changes. For example, a substantial portion of the QPP proposed rule is devoted to CMS' intent to implement MIPS Value Pathways (MVPs) that would transform the way providers participate and what measures they must report starting 2021. While these changes are not slated to take effect next year, many providers are concerned about the disruption that the new framework may cause and the uncertainty of how MVPs would be implemented operationally. IT leaders must stay on top of on the potential changes, so that they are prepared for any changes that must be implemented to the systems that providers use to collect and report MIPS data.  Join our webconference on September 3rd at 3 p.m. ET for our take on how MVPs will impact providers in the QPP, and the overall policies proposed for how Medicare wants to pay providers in 2020.

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How to navigate the land of MIPS

Use this map to understand Merit-based Incentive Payment System (MIPS) participation requirements, how performance is measured, and the financial impact.

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