MACRA – It’s All About Quality

Health care delivery will be dramatically changed with the adoption of the Quality Payment Program. Providers, administrators and health IT professionals will all be impacted by MACRA and the interoperability requirements it brings.

Increasing Flexibility and Encouraging Adoption

The Medicare Access and CHIP Reauthorization Act (MACRA) was passed in April of 2015 with bipartisan support and established the Quality Payment Program. The goal of the legislation is to reward better care, tying payments to quality – not quantity. MACRA sunsets the irreparably broken SGR (Sustainable Growth Rate) and replaces PQRS (Physician Quality Reporting System), VBM (Value Based Modifier) and the EHR Incentive Program (Meaningful Use).

The priorities of CMS and U.S. Department of Health and Human Services (HHS) in the creation of MACRA include increasing the flexibility of Meaningful Use, encouraging the adoption of user-friendly technology designed around how providers treat and interact with their patients, and improving the information exchange between different healthcare providers and patients as health data is moved between different environments and health systems.

Small Practices are Most Vulnerable Under MACRA

The U.S. Department of Health and Human Services (HHS), announced a plan to help small practices get the information they need to effectively participate in MACRA. HHS wants small practices to be able to thrive under MACRA and has set aside $100M in funding for organizations to consult with small practices to help them prepare for MACRA. From their website:

“ [Consulting] organizations receiving the funding would support small practices by helping them think through what they need to be successful under the Quality Payment Program, such as what quality measures and/or electronic health record (EHR) may be appropriate for their practices’ needs.”

This is one reason we’ve created QIE Standard – the ideal solution for small clinics & low volume interfaces, a fully-featured free version of the Qvera Interface Engine that is limited only in throughput and number of channels. In our view, small practices should have the same powerful interoperability tools as large organizations, especially with new laws (like MACRA) and standards (like FHIR®) emerging.

Check back next week for our continuing discussion on MACRA and Interoperability.