As the end of 2014 approaches let’s take a look at the HIT events of the year.
Twelve Drummers Drumming
Meaningful Use has had a constant drum beat in the blog this year. Terry started 2014 with MU stage 1, 2 and 3 details, including information on 2013 attestation and the 50% Rule in January posts. MU2 changes this year include the required reporting for 9 of 64 Clinical Quality Measures (CQMs) covering 3 of the 6 National Quality Strategy (NQS) domains and the overlap with PQRS for this reporting. MU2 hit the brakes in May with the notice of proposed rulemaking (NPRM) that became a final rule delaying MU2 required reporting to 2016 and MU3 reporting to 2017. MU drumming slowed to an occasional tap in the second half of the year.
Eleven Pipers Piping
The “Doc Fix” or SGR Repeal and Medicare Provider Modernization Act was a familiar tune from congress this past February. Despite 2 options for a permanent SGR fix, Congress did not act on a permanent change. Physicians received another patch to maintain the status quo through March 2015 and avoid the more than 24% physician pay cut in Medicare reimbursement.
ICD 10 continues to stay a leap ahead. Last February Terry posted about preparing for ICD 10 transition on September 30, 2014, noting the U.S. is behind other industrialized countries that are already using ICD 10. On March 31, in a fit of March Madness, the Senate passed H.R. 4302, the Protecting Access to Medicare Act of 2014, which delays ICD 10 implementation “until at least October 1, 2015.” ICD 9 has been in use since 1978 and the World Health Organization will release ICD 11 in 2017. Maybe we’ll leap right over ICD 10.
Nine Ladies Dancing
The Value-Based Payment Modifier (VM) was introduced in the February 3 blog post as a “rock our world” change in health care. Large practices are already dancing with surveillance in 2013 followed by VM application to Medicare payments in 2015. Practices with 10 or more providers were observed during 2014 and will step onto the dance floor in 2016, and everyone’s rocking by 2017. Acumen blog posts have outlined key VM tiers and strategies. In the July 21 post “The Physician Value-Based Payment Modifier (VM): Is the Emperor Wearing Clothes?” details are provided about 2015 PQRS reporting to avoid the VM penalty.
VM brings us right to the daily work of PQRS: the 8-year, pay-for-reporting, old-brown-milk-cow CMS program. 2014 is the last year of PQRS reporting incentive, but participation will save you from the 2016 penalty. As noted in the Acumen blog on April 14, PQRS is a program that reports on process metrics not outcome metrics, so it has been a stepping stone to the new pay-for-performance programs.
See the July 7 blog post for details about staying afloat with your EHR Security Risk Analysis as part of Meaningful Use. Use of a certified EHR does not meet the requirement for compliance attestation with the HIPAA Security Rule. If you are in the 5% of practices chosen for a pre- or post-payment MU audit, then you will need to submit a security risk analysis.
This year has been filled with the golden eggs of personal health devices that are enriching individual health data, enhancing patient engagement, and initiating continuous health monitoring. During the 2014 National Forum on Data Analytics the Office of the National Coordinator for Health Information Technology (ONCHIT) highlighted the focus on active patient engagement and personal health data contribution.
Five Gold Rings
Patient Portals may be the golden ring of patient engagement. A functional patient portal that provides secure electronic messaging with patients is a 2014 MU requirement for Eligible Providers (EPs). This year Acumen EHR achieved the ONC 2014 certification as a complete EHR with enhancements including a robust patient portal.
Four Calling Birds
If the government comes to your practice calling for a Meaningful Use audit you want to be prepared. Each year approximately 5% of practices participating in Meaningful Use will experience an audit. Check out “Terry’s Tips” from the July 7 post to be ready.
Three French Hens
The rare French Hens are a reminder of the foraging we will be doing for nephrologists in the coming years, as the number of nephrology fellows continues to dwindle. The September 22 blog post covered the 2013–2014 National Residency Matching Program specialty matching service report showing that only 76% of nephrology fellowship positions were filled. Last week the American Society of Nephrology reported that 51% of nephrology training programs and 32% of fellowship positions were NOT filled in the recent 2014–2015 specialty match. 120 nephrology fellowship positions are unfilled for the upcoming year. Nephrology fellows are as rare as hen’s teeth.
Two Turtle Doves
Check out the October 27 blog post to learn more about the 2 parts of the Quality and Resource Use Report (QRUR): quality and cost. As Terry describes in this post, the QRUR has your practice quality data across the PQRS measures and cost data across Medicare Part A and Part B claims for patients attributed to your practice. In the end the QRUR provides a glimpse into the future of VM for your practice.
A Partridge in a Pear Tree
I’ll end this festive holiday post with a true 2014 highlight from Regina Holliday: The Walking Gallery story. Health IT News published a list of “Health IT Change Agents” for 2014 and artist Regina Holliday is on this list for her creation of The Walking Gallery, the cornerstone of her work for patient advocacy. Check out Regina’s story on her blog. For a reminder of why we come to work every day, watch a wonderful short video about The Walking Gallery at this link.