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Improved Patient Care

The proposed rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) has given way to a major new development. From now on, EHR programs will be folded the Merit-Based Incentive Payment System (MIPS), starting January 1, 2017, according to a news conference announcement by CMS’s acting administrator, Andy Slavitt.

Slavitt said that the MU program will now be succeeded by Advancing Care Information, which will have fewer measures than the current program. ACI comes with additional flexibility in meeting specified criteria, and will emphasize the use of IT in patient care improvement. Under the new program, Eligible professionals (EPs) will not be required to meet every single requirement, the way they do at this time.

The proposal will accommodate physicians’ and other EPs’ attainment of 50% credit for the act of reporting itself, and the measures will no more include clinical decision support or computerized physician order entry. The other half of the score will be based on the EP’s performance on these measures, with clinicians getting the option to choose those metrics which are most meaningful to their practices. The number of measures has been brought down from 18 to 11.

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The three main objectives for this program are improved interoperability in HIE, flexibility, and “user-friendly” technology, blogged Slavitt and Karen DeSalvo, MD, national coordinator for health information technology (IT) and assistant secretary of health. Both of them have stressed that government is seeking developers who can start using open application programming interfaces which will soon be published by the Office of the National Coordinator for Health IT. One of the main goals for ACI is to get set up means for patients to access their health information through these interfaces. DeSalvo said at the press conference that application programming interfaces would be helpful to developers in meeting provider’s expectations for usable health IT systems.

Also, EPs require EHRs which can meet the criteria for Advancing Care Information. DeSalvo has noted that the proposed rule is “aligned” with certified EHR technology of 2015, but that the version will not be mandated till 2018. For this reason, the new criteria will be adjusted towards the 2014 versions of EHRs that a huge majority of providers are using at this time. This was announced by Kate Goodrich, MD, director of the Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality, who added that EPs can use the older EHR technology till 2018.