The End of MU… Oh, Never Mind!

Lynn Scheps

Lynn Scheps

VP, Government Affairs & Consulting Services at SRS Health
Lynn Scheps is a leading resource on MACRA, MIPS, and Meaningful Use. She is the SRS liaison with government policy makers. Representing the voice of specialists and other high-performance physicians, she develops strategies to respond effectively to government initiatives.
Lynn Scheps

chameleon-315pxAccording to a recent speech by Andy Slavitt, Acting Administrator of CMS, “The Meaningful Use program as it has existed will now be effectively over.” Not surprisingly, the media picked up this news—particularly the word “now”—and ran with it, gleefully proclaiming the “End of MU in 2016,” “CIOs Celebrate End of MU,” “MU on Deathwatch,” etc. It was easy to believe that Slavitt was predicting the demise of MU to be imminent since the stated topic of his talk was “policy areas that will affect the healthcare sector in 2016.” However, in Tuesday’s CMS Blog, Slavitt—writing with Karen DeSalvo—walked his statement back a bit. That said, this is still quite significant news: CMS has formally acknowledged what Slavitt himself referred to as the frustration and burden that physicians have been dealing with since the start of MU.

The key phrase in his statement about MU is “as it has existed.” MU is to be, in Slavitt’s words, “replaced with something better”—i.e., a new and improved version of itself. It is not going away. We already knew that MU had been identified as an integral part of a new program called MIPS under MACRA, the regulations for which are still being written by CMS. MACRA, the legislation that replaces the Medicare Fee Schedule’s SGR calculation, becomes effective in 2017, with a new schedule of payment adjustments (a.k.a. incentives and penalties) beginning in 2019.

Slavitt’s “announcement” was clouded by uncertainty, but was greeted, nevertheless, with great jubilation and high expectations, some of which were dashed by the clarifications published in the subsequent CMS Blog. In his speech, Slavitt had provided little insight into exactly how MU will be restructured. It begged the questions: Will the changes to the requirements be radical enough to be perceived by physicians as “something better?” What will become of the Stage 3 Rule, which is currently undergoing finalization and is due to go into effect in no later than 2018? And, will the MU penalties scheduled for 2017 and 2018 remain in effect or be eliminated? The CMS Blog answered some of these questions, to the disillusionment of many providers:

  • The current law requires that we continue to measure the meaningful use of ONC Certified Health Information Technology under the existing set of standards.
  • We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations—including meaningful use Stage 3—are still in effect.

Despite the myriad details yet to be determined, what we do know about the future is that physicians will increasingly be rewarded for quality over quantity of care. Therefore, a critical component of the new government programs will be the demonstration and reporting of improved patient outcomes (most likely in PQRS fashion). We can also be confident that MACRA (and any new version of MU it contains) will demand heightened interoperability and patient engagement, and physicians will have to meet requirements that support these goals.

The question of timing notwithstanding, should you be excited about this announcement? I would suggest cautiously so. We are optimistic that the anticipated changes will bring some relief from the unnecessary administrative burdens with which physicians have been struggling and let them get back to focusing on the practice of medicine. But unless concomitant changes are forthcoming on ONC’s side to streamline the excessive EHR certification requirements on the books for 2017/2018, EHR developers and vendors will still not have the necessary time or freedom to focus on innovations that would deliver the efficiencies and clinical benefits that would be of maximum value to physicians and their patients.

As always, SRS will keep you up to date on all developments in this area as they are revealed over the next few months. Please feel free to contact Lynn Scheps, Vice President, Government Affairs, if you have any questions.

10 Crucial Questions to Ask EHR References

5 Star RatingToday, we are used to searching for references for everything from restaurants and hotels, to clothing labels and wearable fitness technology. Whether you are planning a party or searching for a new physician, gathering a handful of reviews can help inform your selection.

Collecting EHR references is one of the most critical steps in the EHR search process. To ensure your reference gathering is as effective as possible, make sure several members of your staff are onboard. If each employee makes a few calls, the interview process will not require a large time commitment from any one of them.

Second, both administrative staff and physicians should call and speak to several of their peers at the reference sites to collect a variety of different perspectives and opinions.

Finally, don’t just call the references provided by the vendors—find other practices using the EHRs you are considering by joining professional society listservs such as MGMA’s and AAOE’s.

Once you’ve collected 10 references of similar size within your specialty from each EHR vendor—along with a few practices that weren’t provided by the vendors—ask each reference these 10 crucial questions:

  1. When did you install your current EHR?
  2. How long was the installation/implementation process?
  3. How would you describe the installation/implementation process?
  4. Was the system as easy to use as it appeared to be during the software demonstration?
  5. How has your patient volume changed?
  6. Approximately how much more time do you devote to entering exam data into your EHR as compared to how you documented exams before you began using this EHR?
  7. What percentage of your exam notes are fully-templated?
  8. Do you like the quality of the exam note generated by your current EHR? Does it represent you well?
  9. How have your patient interactions changed?
  10. Would you recommend your EHR to a similar practice?

Asking these questions will give you a clear indication of whether or not a specific vendor will be able to deliver the success you expect from your EHR implementation.

Keep this “cheat sheet” of reference questions handy throughout your EHR search process. It will prove invaluable and provide you with the information you need to save yourself from a potential mistake.

What are some additional questions you would ask of references?

Patient Engagement: Build a Strategy for Patient Empowerment

Christine Schiff

Christine Schiff

Government Affairs Specialist at SRS Health
Christine has been with SRS for over 5 years, working in Government Affairs and serving as the HIPAA Privacy Officer. She is devoted to providing excellent customer service, and she translates this passion into the work she does to support government program compliance. She has an expert understanding of MU and PQRS and serves as a valuable client resource.

Prior to joining SRS, Christine worked at NYU for 11 years where she also obtained her Bachelor of Science in Healthcare Management.
Christine Schiff

dr-patient-selfie-42511727_sRemember the days when the provider-patient relationship was centered primarily on the interactions that occurred during a visit? Whether it was in the exam room, over the phone or at the hospital, these were the places where the provider-patient relationship was built. Now, patient care encompasses more than just the traditional office visit and a physician’s bedside manner. A lot more emphasis is being placed on the patients—engaging and empowering them to partner in the healthcare process.

Patient Engagement is a hot topic in healthcare – a quick google search and you’ll come up with countless references to infographics, successful approaches, and tools to help build a patient engagement strategy. You will also find articles that discuss how patient engagement can have positive effects on improved quality of care and patient outcomes. The frameworks vary from simplistic to more complex, but the common theme is partnering with your patients and building ownership of their health and healthcare. Some examples of an effective PE strategy include: providing patient-specific education, making patients’ health information available online, including the patient in developing care plans and coordinating with other caregivers.

With an increased focus on patient engagement and interoperability incorporated in Meaningful Use Stage 2, many of these suggested practices can be accomplished using your EHR. Although many providers are anxiously awaiting the Final Rule Modifying MU Stage 2 in 2015 – 2017 and hoping for lower thresholds on the patient engagement measures like Patient Electronic Access and Secure Messaging, it is safe to say these measures are here to stay and will have increasing threshold(s) over the next few years.

So if there was ever a time to start building or improving upon your engagement strategy – the time is now! Whether you go at it on your own or use your EHR to help accomplish these goals the resources are abundant. What will your strategy include? Maybe you’ve been actively engaging patients for years and have some best practices to share. What helps to empower your patients?

Doctors: Not a Jack of all Trades… A Master of One!

Helene Kaiden

Helene Kaiden

Vice President, Marketing at SRS Health
Helene Kaiden is the Vice President of Marketing for SRS, with responsibility for building brand awareness, educating the marketplace, and driving sales opportunities. Helene’s team of creative marketing professionals has a charter that includes marketing strategy and programs, product positioning, digital marketing, conferences, and analytics. Helene’s powerful commitment to excellence and dedication to helping clients address their medical-practice challenges drives her messaging strategies.

Helene received a Bachelor’s degree in Consumer Economics from Cornell University, with a concentration in Business Management. She has over 20 years of experience in sales and marketing roles.
Helene Kaiden

Doctors: Not a Jack of all Trades… A Master of One!As the leader of a high-performance marketing team, I strive to stay abreast of the latest developments and best practices in the HIT industry and my chosen profession. But, no matter how prepared I am, I cannot be successful at what I do if I am expected to be an expert in every aspect of marketing. My expertise in leadership, building teams that excel, and developing professionals to reach their highest abilities, does not prepare me to be successful at writing HTML code, or designing graphics in the latest style. I need a team of experts to contribute their individual talents if we are to succeed.

This is even more apparent in the medical profession. In today’s world doctors are expected to not only be experts in their particular medical field, they are also expected to be experts in human resources, business management, and a plethora of other disciplines that serve their practice needs and government requirements. Besides earning an M.D., they practically need an M.B.A. in order to run a profitable and growing business. They also have to be policy analysts and experts to even have a chance of understanding the volumes of regulations the government has enacted and with which they’re expected to comply. In addition, they are expected to be IT specialists in order to meet data exchange and interoperability demands. And don’t even get me started on the statistical analysis required to understand outcomes and value-based reimbursements.

I expect that one of the reasons that doctors chose their profession in the first place was because they had a passion for science and service. So, to focus on the profession for which they have been educated and prepared, doctors need to find other experts to support them by focusing on the business of medicine.

It all comes down to one thing… the patient. In order to best serve your patients’ needs you must spend your time mastering the art of medicine, while letting your team of experts master the art of your business.

A final prognosis: building a strong team of experts will ensure the health of your patients and practice.

Where is your focus directed?

Dreams vs. Reality

Scott Ciccarelli

Scott Ciccarelli

CEO at SRS Health
Scott Ciccarelli, Chief Executive Officer at SRS, has more than 20 years of diverse management and operations experience garnered as a senior executive at GE, where he headed two of the company’s businesses—most recently, GE Healthcare’s Services, Ambulatory and Revenue Cycle Solutions. His areas of expertise include business strategy, leadership development, operational rigor (Lean Six Sigma), and the delivery of enhanced value for customers through quality improvement and innovation.
Scott Ciccarelli

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“I want to be a doctor when I grow up.”superman

What did you want to be when you were growing up? I wonder how many of today’s physicians, knowing what they know now, wish they could turn back time and change that childhood ambition. That calling. That innate drive to help people. Because after devoting countless grueling hours to schooling, internships, and residencies… after earning a reputation based on providing personalized care, one patient at a time… after building a business based on an immeasurable combination of talent and knowledge, suddenly the field of medicine is being commoditized. No wonder physician burnout is on the rise—up 16% in two years, according to this Medscape Physician Lifestyle Report.

The government is telling doctors that an EHR can absorb mass data and spit out the right answer better than they can. Doctors are paying more to run their practices, earning less, and are still expected to provide quality care for record numbers of patients. And those patients have no idea what is going on behind the scenes, so their satisfaction levels are at risk. As physicians aim to fulfill their Hippocratic Oath in this world where they also are required to mitigate their own legal risks, direct their attention away from humans and toward technologies, and follow data directives based on masses instead of their own professional insights, the people on both sides of the examination table are feeling it.

In a recent survey, PhysiciansPractice.com published a list of things physicians wish patients knew. Here are some of the findings:

• “I wish they knew why physicians usually run late.”

• “I wish they knew that I do care about the pain they are having… even if I seem busy or preoccupied.”

• “I wish they knew how often we have to fight with their insurance companies just to get paid for services we’ve rendered.”

When it comes to practicing medicine, there are no limits to the differences that can exist between cases—and allowing physicians to discern those nuances is critical to providing the best patient care. Rather than getting caught up in the negativity surrounding these ongoing changes, I’d like to ask these professionals for whom I have tremendous admiration to weigh in.

Doctors: What changes would make practicing medicine more in line with the reasons you chose to become a physician?

Providers’ MU Prayers Answered?—Quarterly Reporting for 2015?

Lynn Scheps

Lynn Scheps

VP, Government Affairs & Consulting Services at SRS Health
Lynn Scheps is a leading resource on MACRA, MIPS, and Meaningful Use. She is the SRS liaison with government policy makers. Representing the voice of specialists and other high-performance physicians, she develops strategies to respond effectively to government initiatives.
Lynn Scheps

Meaningful Use

In the inimitable style of government-speak, CMS recently announced its “intention to consider proposals” to shorten the 2015 meaningful use reporting period from a full calendar year to 90 days. While I would advise providers to be cautious about changing their plans until the relevant rule is published (anticipated in the spring), I think it is fair to assume that CMS would not have issued even such a noncommittal-sounding announcement if it were not planning to actually implement this change.

CMS has finally yielded to the relentless lobbying by the AMA and an alphabet soup of other professional societies and HIT organizations, all of which remain concerned about provider readiness and the challenges presented by an insufficient infrastructure to support Stage 2 requirements. Objections to full-year reporting for 2015 date back to last spring, when comments were submitted in response to the (then-proposed) 2014 Flexibility Rule. At that point, CMS adamantly rejected the overwhelming number of comments that recommended—or pleaded for—quarterly 2015 reporting. Currently, however, in addition to this external pressure, the dismal number of Stage 2 attestations to date has got to have CMS worried about the future of its MU program.

The devil, as always, will be in the details:

  • When will the rule be available, and will its timing be early enough to avoid creating the aura of uncertainty that characterized last year’s mid-year revisions? (We are already one month into the 2015 physicians’ reporting period, four months into the hospitals’.)
  • Would quarterly reporting be available to all providers, even those still at Stage 1?
  • What happens to “harmonization’ with PQRS, which remains a full-year program? (This has been one of the reasons CMS has stated for its resistance to quarterly reporting.)

Even more intriguing to me than the change in reporting period is the second of the three proposals enumerated as being under consideration—that is, the intention to modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.” Is it possible that CMS is taking the advice of the AMA and other organizations to increase flexibility, reduce the number of measures, add more choice, and maybe even eliminate the all-or-nothing nature of MU? Wouldn’t that be something!

Let us know what you think by submitting a comment below.