The final MACRA rule aims to reform Medicare payment model and offer more flexibility to physicians by simplifying some difficult data reporting requirements. However, some experts argue that the same rule might be nagging for small heath IT vendors, who are experiencing issues with upgrading their existing technology to be more relevant, patient-friendly, and specialty-specific.
MARCA requires providers to participate in either Advanced Alternative Payment Models (APMs) or Merit-based Incentive Payment System (MIPS). The final rule in MACRA ends payment adjustments that fall under the EHR incentive program, although some parts of the program would be still categorized under MIPS.
Physicians that choose MIPS will be reimbursed based on their performance in four categories – quality, clinical practice improvement, cost, and advancing care information, which substitute the Meaningful Use program. However, reports say that ‘cost’ would not affect the physician score for the 2017 reporting period. Moreover, those who choose APMs will be exempted from MIPS requirements, but would have to use certified EHR systems.
According to a report by the National Coordinator for Health Information Technology, around 75 percent of participants in the Medicare EHR Incentive Program use an EHR technology that is certified for 2014. However, when under APMs, physicians are required to use 2015-certified EHR technology to be eligible for the reimbursements. This requirement may be troublesome for small EHR vendors, who have recently upgraded their technology for the 90-day reporting period.
According to Corinne Proctor Boudreau, who is the senior marketing manager for physician experience at Meditech, a hospital and physician EHR developer, “You have seen some of those smaller vendors not be able to make those requirements (under the Meaningful Use program). But this is the direction the industry has been going in. It’s a little bit the cost of doing business.”
Contrastingly, Allison LaValley, executive director for quality performance and value-based care at Athenahealth, said that, “This situation is unfortunate for providers who have invested in an EHR that does not acclimate to agile change at scale. As a cloud-based network, we are very nimble and can adapt not just to MACRA but to anything the government throws forward.”
This makes it clear that small vendors would be more troubled with the implementation of the final rule in MACRA, than large providers would. Nonetheless, vendors are not obliged to update their technology under MACRA, even though physicians’ qualifications heavily depend on their alliance.