There has been an overwhelming number of legislative changes in the healthcare industry in recent years, especially since the passage of the Affordable Care Act. Recently, as part of an attempt to cut costs and increase the overall efficiency of the system, there has been an emphasis on revamping legislation to take into account technological advances and progress.
MACRA and Interoperability
Recent legislation, the Medicare Access and CHIP Reauthorization Act (MACRA), was passed to help integrate technology into the existing healthcare system. But, as the Workgroup for Electronic Data Interchange (WEDI) has said, more needs to be done to promote interoperability for health data, according to HealthIT Interoperability.
The main disconnect between the law and potential best practices within the healthcare industry is regarding incentives for providers and IT developers.
“WEDI’s Payment Model Workgroup is very enthusiastic about the opportunity MACRA implementation presents to accomplish the goals of CMS, payers, eligible clinicians, technology vendors, and so many others,” said Charles W. Stellar, president and CEO of WEDI, in the press release. “The use of incentives and enabling technology to improve quality and promote smart spending in healthcare is crucial as we all work to create significant advancement in value-based reimbursement.”
The WEDI also stressed that a main component of the new interoperability measures is security, as information needs to be protected and patient data never compromised. WEDI also noted that eligible clinicians and groups would need to rollout data and performance measures with the help of the Centers for Medicare and Medicaid Services (CMS) – this would help to promote industry-wide adoption guidance.
It wasn’t just WEDI that commented on MACRA, as the American Medical Informatics Association also spoke to the potential for CMS to increase interoperability across the entire industry, especially with regard to third-party technology companies.
“CMS should work with its federal agency partners to identify technical standards that would facilitate the exchange of information between third party intermediaries,” AMIA President & CEO Doug Fridsma, MD, PhD, and Board Chair Thomas Payne, MD.
Potential Cuts Highlight Urgency of Technological Advances
The need for interoperability measures and other technological advances is also increasing because of potential budget cuts, especially for older patients. According to Modern Healthcare, home healthcare agencies may see a 1 percent drop in Medicare reimbursement in 2017.
When such significant cuts – the CMS cut payments by $260 million for 2016, $60 million for 2015, and $200 million for 2014 – occur within the home healthcare sector, new methods of care must be implemented.
Though the cuts may affect the home healthcare sector and patients who rely on these services, more could be done to provide remote services to replace the lack of in-person care. This is where technological advances, which can link physicians with patients through remote monitoring applications and devices, can make up for budget shortfalls.
How interoperability measures, increased technical standards, and redefined care coordination models will solve these problems is yet to be defined fully. However, the framework is being built and providers are beginning to see results.