MACRA rule adds EHR flexibility, pushes back mandate for 2015 editions

By allowing doctors to use either 2015-certified electronic health records or legacy versions, the program will enable better interoperability, experts say.
By Bernie Monegain
12:25 PM
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The Centers for Medicare and Medicaid Services on Tuesday delivered a 2018 MACRA proposed rule that would add more flexibility to the health IT mandates associated with the law.

The proposal pushes back the requirement that clinicians use 2015-certified electronic health records for another year. Instead, doctors can continue to use legacy systems if they choose and those that opt to use 2015 editions would get a 10 percent payment bonus from CMS.

“The proposal to reward those clinicians who demonstrate a more advanced use of health IT to support patient care through 2015 Edition CEHRT will improve interoperability and provide patients with better access to their data,” said American Medical Informatics Association CEO Doug Fridsma, MD.

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The new rule aims to move the country’s healthcare system from a fee-for-service approach to one centered on value-based care and aimed at improving patient health. CMS also intends to boost care access for Medicare and CHIP beneficiaries through MACRA. 

Clinicians who need more time to upgrade or adopt 2015 Edition CEHRT, meanwhile will benefit from another 90-day reporting period.

Fridsma also gave CMS kudos for expanding the list of “improvement activities” that can count as bonus payments for the MIPS System’s Advancing Care Information performance category.

“This helps credit clinicians for using health IT within a care improvement context, and we see this as a more outcomes-focused approach to measuring health IT use,” Fridsma said. 

One of CMS’ stated goals is to simplify the Quality Payment Program, especially for small, independent and rural practices, an issue that has the attention of healthcare leaders.

“We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient,” CMS Administrator Seema Verma said in a statement. “That’s why we’re taking a hard look at reducing burdens. By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork.”

Both the American Medical Association and the American Hospital Association publicly showed support for the proposed rule. 

“Many doctors see MACRA's requirements as daunting, but Tuesday's proposed rule helps settle those fears,” AMA President David Barbe said. "This flexible approach will give physicians more options to participate in MACRA and takes into consideration the diversity of medical practices throughout the country."

AHA Executive Vice President Tom Nickels added that the rule brings its members "much-needed relief from unrealistic, unfunded mandates for EHR capabilities" by extending modified Stage 2 requirements through next year. "We encourage CMS to provide the same relief to hospitals.” 

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com


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