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New ONC Metrics to Measure Interoperability
On July 1, the Office of the National Coordinator for Health IT (ONC) announced via the HealthIT Buzz blog two new metrics for assessing "widespread interoperability," as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA):
Measure 1: Proportion of providers electronically engaging in the following forms of health information exchange: sending; receiving; finding (querying); and integrating information received from outside sources.
Measure 2: Proportion of providers who report using the information they electronically receive from outside providers and sources for clinical decision-making. The metrics will not require additional reporting by physicians, as the data can be gleaned from existing surveys of hospitals and office-based physicians. This requirement is separate from the provisions that the Department of Health and Human Services (HHS) has proposed to implement through the Quality Payment Program for payment of office-based Medicare physicians.
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EIDM Accounts Necessary to Obtain 2015 PQRS Feedback Reports and 2015 Annual Quality and Resource Use Reports
CMS will be releasing two reports in early fall that will require Enterprise Identity Management (EIDM) accounts to access. The reports scheduled for release are:
PQRS feedback reports depicting your program year 2015 PQRS reporting results, including payment adjustment assessment for 2017. 2015 Annual Quality and Resource Use Reports (QRURs) that will show how groups and solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier. Prepare now by either signing up for an Enterprise Identity Management (EIDM) account or ensuring that your existing account is active. EIDM accounts are required for participants to obtain 2015 PQRS feedback reports and 2015 Annual QRURs. The same EIDM account can be used to access both reports. To register for an EIDM account, visit the CMS Enterprise Portal and click "New User Registration" under "Login to CMS Secure Portal."
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Bundled-Payment Expansion Brings Providers More Risk — and Opportunity
The CMS announced a proposal last week to put three new episodes of care under mandatory experiments with bundled payments, potentially compelling hundreds of additional hospitals into becoming financially accountable for what happens to Medicare patients long after they leave the hospital. It was just one in a series of steps in an effort to move Medicare and the entire industry toward models that pay for the quality of healthcare rather than the quantity of services.
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Unencrypted Phone + Patient Data = HIPAA Breach
An unencrypted cellphone with no password protection cost Catholic Health Care Services of the Archdiocese of Philadelphia $650,000. An employee lost the phone, which contained patient data. The Office of Civil Rights (OCR) determined this was a HIPAA breach because there was no password or encryption on the device. The OCR and FTC, jointly, as well as the National Institute of Standards and Technology, have released guides to help address these issues.
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CMS Proposes Changes to the Medicare and Medicaid EHR Incentive Programs
On July 6, CMS released the Calendar Year (CY) 2017 Changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule. This rule includes a number of proposed changes that would affect the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The proposed changes to the Medicare and Medicaid EHR Incentive Programs, include: Eliminate the Clinical Decision Support (CDS) and Computerized Provider Order Entry (CPOE) objectives and measures beginning in 2017 and reduce the thresholds for a subset of the remaining objectives and measures in Modified Stage 2 in 2017 and Stage 3 in 2017 and 2018 for eligible hospitals and critical access hospitals (CAHs) attesting under the Medicare EHR Incentive Program. Please note that these changes would not apply to eligible hospitals and CAHs that attest under a state’s Medicaid EHR Incentive Program; Propose a 90-day EHR reporting period in 2016 for all eligible professionals (EPs), eligible hospitals, and CAHs; Require new participants (EPs, eligible hospitals, and CAHs) to attest to Modified Stage 2 by October 1, 2017 to avoid the 2018 payment adjustment; Allow certain EPs, who are new participants that intend to attest to meaningful use for an EHR reporting period in 2017, and who intend to transition to MIPS and report on measures specified for the advancing care information performance category to apply for a significant hardship exception from the 2018 payment adjustment; Changing the policy for measure calculations such that, for all meaningful use measures, unless otherwise specified, actions included in the numerator must occur within the EHR reporting period if that period is a full calendar year, or if it is less than a full calendar year, within the calendar year in which the EHR reporting period occurs.
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