What to Watch in 2012

Happy New Year everyone and welcome to 2012!

 

Last week I reviewed some of the pertinent health IT developments that occurred in 2011. Today let’s look at a few trends deserving attention in 2012. In no particular order:

1. Meaningful Use—Since many practices put off starting until 2012, I think we will see a surge in participation this year among nephrologists. One reason is the “time-stamped” nature of the Medicare incentive. If you wait until 2013 to begin, you will leave as much as $5,000 in incentive payments on the table over the course of the program. The behavioral economists would suggest the concept of loss aversion makes this even more painful and, in fact, may drive greater participation. While we are discussing meaningful use, let’s not forget to mention the Stage 2 objectives should be finalized sometime this summer.
2. Accountable Care Organizations—The ACO final rule is out and over 30 pioneer ACOs have been identified. Health IT will be a fundamental component of every successful ACO. Nephrologists may not be involved in this initial pass, but this is certainly a trend we need to pay close attention to.
3. Performance Measures—Now a clear trend among payers, reporting specific performance measures to CMS and others will likely continue to expand. I think, increasingly, we will see a trend towards capturing this data electronically. The PQRS program provides a good example of the evolution of this trend. The program began with the submission of quality data codes along with the Medicare beneficiary’s claim. Today the majority of PQRS measures are reported electronically either through a Registry or directly from an EHR. The days of reporting quality data on a paper claim may be numbered.
4. Public Reporting—As part of their drive towards transparency and value-based purchasing, CMS is increasingly moving towards public reporting of quality data. To that end they have established the Physician Compare web site. This is clearly a work in progress, but in early 2013 it will display actual PQRS performance scores for group practices reporting PQRS data via the Group Reporting Option. I suspect in future years individual provider performance scores will make their way onto this web site.
5. P4R Transitions to P4P—This may be a little premature, but I believe the days of being paid an incentive for simply reporting data to CMS will soon give way to performance-based incentives. We caught a glimpse of this with a subtle change to the PQRS program last year. If you submitted an individual PQRS measure in 2011 with a performance score of zero, CMS will treat that as though you did not report the measure. In other words, reporting a performance goose egg results in no payment. I think we can learn a lot about this trend by observing the evolution of the ESRD QIP program that dialysis facilities are compelled to participate in today.
6. Mobile Computing—The proliferation of smart phones and innovative tablets like the iPad not only dominates the personal technology space but Health IT as well. This raises a number of issues, including data security and device control policies. Regardless, this trend appears unstoppable and increasingly Health IT vendors are striving to accommodate demand.
7. Health Information Exchange—HIE will continue to evolve in 2012. Exchanging clinical data electronically is one of the three principal foundations of the meaningful use program. As the “train tracks” for data exchange become increasingly robust, some of the promise of the meaningful use program will be realized. While this may not come to fruition during 2012, I think the industry will make great strides in this direction this year.
8. ICD-10—Not to end on a down note, but let’s not forget that the deadline for the ICD-9 conversion to ICD-10 is looming. I must confess, typing that last sentence was a bit uncomfortable. Bottom line: We have about 20 months and 29 days between now and the October 1, 2013, deadline for compliance. But who’s counting?

I am sure there are many topics I have not mentioned. If you have a favorite, please post it below.

 

I would like to join the team at Health IT Services Group in wishing each of you a happy and prosperous 2012!