Addressing the elephant in the room: How to prepare for MACRA & the consumer-facing world

Technology will play an integral role in the consumer-driven healthcare field, with legislative changes including CMS' Medicare Access and CHIP Reauthorization Act of 2015 demanding more data illustrating superior patient outcomes. During a panel at Becker's 2nd Annual CIO/HIT + Revenue Cycle Conference, panelists highlighted how health IT will propel organizations forward, where it needs to go and how MACRA will come into play.

"There is a big elephant in the room with a bubble that says MACRA," said Samir Batra, VP of patient engagement for Oneview Healthcare, with U.S. headquarters in Pittsburgh. "CMS claims they are trying to finish what they started with Meaningful Use. It is something we can't chase away, and patients will be at the center of the care delivery model."

Patients are paying more for healthcare and the patient experience extends far beyond hospital walls. Technology is giving patients and providers many options for obtaining and sharing data, but the challenge is using the data in a way that is meaningful for all parties involved in a patient's continuum of care.

"Pushing information onto patients will never work. Some patients say they would rather not deal with a portal because it is easier not to," said Vikram Sobti, MD, DABR, chief medical information officer for Norwegian American Hospital in Chicago. "The way you can make a portal more robust is to make it a good experience for the patient."

Randy Osteen, associate CIO and VP of information management for CHRISTUS Health, headquartered in Irving, Texas, noted some hospitals have six or more different portals, deterring patients from using these portals. "If you went to Amazon and had to log in six different times, you probably wouldn't do business with them," he said.

To drive meaningful change from data, interoperability is key and it is a challenge hospitals continue to face. Electronic referrals have helped South Carolina Health Center better manage what is happening with their patients because they get access to provider information across a patient's continuum of care, the center's CIO Sherri Shults, RN, noted. However, Dr. Sobti argued a lot of progress has to be made in interoperability because it is in the patient's best interest for systems to function at peak operability. Operability will help hospitals avoid redundant information.

With MACRA's implementation, providers will have to input more data into a patient's electronic health records. Therefore, physician alignment is crucial to ensure a hospital bodes well financially in the pay-for-performance system.

"The day MACRA came out, we had a meeting and physicians asked the difference between MU, MIPS and APMs. They called all these acronyms alphabet soup and they are having a hard time grasping it," Ms. Shults said. "We have met Meaningful Use for the past five years, but physicians are scared we will lose that control with MACRA."

Mr. Batra said MACRA's intentions are genuine but may have missed the boat when getting physicians on board. To enhance patient care and truncate costs, MACRA needs to bring physicians into the fold so they fully understand the policy's intricacies and incentives.

"For all its glory, Meaningful Use didn't fare so well with physicians," Dr. Sobti said. "What they lost in efficiency with patients, they didn't make up in incentives. MACRA embodies some of that with a good heart saying we can increase your quality and if you do this properly, you can do well. I am not sure if this will do well on the physician side, but it is a good start."

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