Mandates to Enact Health Policy
Mandates to enact health policy - provide your perspective as an
informatician: Do you agree or disagree with the approach of government
mandates to enact healthcare reforms such as: Implementing EHRs, ICD-10, MACRA?
What are key factors that support government providing a “helping hand” to
implement new technology? What are the factors that support a free market
approach being more successful?
Government
mandates provide a foundation to work towards in order to see a substantial
improvement in healthcare. The enactment of the American Recovery and
Reinvestment Act of 2009 (ARRA), brought about unprecedented funding for
technology in healthcare. This funding has been leveraged in incentive payments
to providers to leverage technology in order to support a continual improvement
of care. The initial approach was a focus on Meaningful Use put in place by the
Health Information Technology for Economic and Clinical Health (HITECH) Act
which provided incentives based on specific measures for using EHR's. Some of
the fundamental guidelines were in place to support improvements in
coordination of care, improvements in public health, and amongst many other
concepts (CDC, 2017). The introduction of the Medicare Access and CHIP
Reauthorization ACT (MACRA), seems more of an enhancement to the payment and
incentive models that hopes to really stimulate a shift toward value-based
care. A shift from solely focusing on meaningful use incentives, MACRA's
primary elements are the quality payment program models which are merit based
incentive payments (MIPS), and Advanced Alternative Payment Models (APMs).
These two payment models promise potential reward for higher value of care which
is no longer solely grounded on technology enhancements, but more data focused.
This shift seems more of a focus on leveraging information to provide better
quality care (CMS.gov, 2018).
EHR
technology overall has had a phenomenal impact on healthcare. With the
enactment of ARRA and incentive programs we have seen a significant upward
trend in physicians using EHR technology. The impact is nearly a double in size
trend from 42% in 2008 to 86% in 2015 of office-based physicians using an EHR
(HealthIT.gov, 2017). Notably the impact of the Meaningful Use incentives to
implement EHR's has had a significant impact on public health which is
reflected in the data. Reporting on immunization data, coordination of care
data, and prescribing data has significantly improved. Post ER discharge data
has increased roughly 50% from 2012 in notifications sent to primary care
physicians (HealthIT.gov, 2015). With that we can expect to see improvements in
coordination of care and moreover, better quality of care being provided to
patients post discharge from an ER. With the capabilities electronic health
records provide physicians, as an informatician I would agree that the
long-term impact technology has on healthcare will shift the industry to a more
value driven industry that stimulates continual improvements of care.
Governments
involvement has a significant impact on healthcare’s rapid implementation of
new technology. These advancements as mentioned support a constant shift
towards value-based care. The incentives provided the necessary funding
needed in order to implement new technology. Without the support government
provided we may not have seen the significant increases in technological
advancements in healthcare. Not only has this increased advancement in
technology but has also provided a new opportunity for technology enthusiast to
create a new market dedicated to health information technology (HIT). With
regards to the overall impact it seems to me that government involvement with
adding regulatory requirements and providing incentives has been the first step
in the right direction. MACRA seems to push this to the next level requiring
that practitioners meet specific measure in order to avoid negative payment
adjustments. Overall the mandates set in place by government are the right
approach if we want to see healthcare move towards a more performance focused
industry.
References:
CMS.gov.
(2018). MACRA. Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html
CSC.
(2017). Meaningful Use: Introduction. Retrieved from: https://www.cdc.gov/ehrmeaningfuluse/introduction.html
HealthIT.gov.
(2015). Hospital Routine Electronic Notification. Retrieved from: https://dashboard.healthit.gov/quickstats/pages/FIG-Hospital-Routine-Electronic-Notification.php
HealthIT.gov.
(2017). Office-based Physician Electronic Health Record Adoption. Retrieved
from: https://dashboard.healthit.gov/quickstats/pages/physician-ehr-adoption-trends.php