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MGMA to New HHS Chief: Health IT Regulations Must be Simplified

February 13, 2017
by Rajiv Leventhal
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The Medical Group Management Association (MGMA) is urging just-confirmed U.S. Department of Health and Human Services (HHS) Secretary Tom Price, M.D., to “significantly reduce the regulatory burden on physician practices” by mitigating or eliminating various health IT regulatory requirements.

The Colorado-based MGMA, which the organization says represents physician groups of all sizes, types, structures and specialties, and has members in every major healthcare system in the nation, said in the letter that the continuation of manual administrative processes that, if corrected, could save the healthcare industry billions of dollars. The letter then outlined a series of improvements that MGMA believes should be on the radar for Price, who was confirmed to his new position by the Senate last week, as it relates to health IT regulations:

  • The Merit-Based Incentive Payment System (MIPS)—MGMA is calling for the simplification of MIPS to permit practices to prioritize effective improvements to patient care. The letter read, “For instance, one of the principal goals of MACRA [the Medicare Access and CHIP Reauthorization Act] was to consolidate three disparate and complex federal quality reporting programs into one. Yet MIPS continues to take a siloed approach to reporting, as it consists of four distinct components under one broad umbrella.” It then offered the following steps for improvement: “For instance, reporting once should count toward the overall MIPS score, rather than merely toward bonus points. Additionally, MIPS should continue to use an ‘any 90 consecutive day’ reporting period to collect data on quality and electronic health record (EHR) metrics and explore sampling and attestation methodologies that ensure statistical validity as an alternative to the onerous data completeness rules. MIPS should not reward the quantity of reporting but the quality of care provided to patients.”
  • Alternative Payment Models (APMs)—The letter stated that physicians have limited opportunities to move into an eligible APM under MACRA in large part because “the regulations establish a restrictive risk standard and the Centers for Medicare and Medicaid Innovation (CMMI) has taken a top-down, government driven approach to developing APMs.” It then said, “We urge a careful review of the eligible APM risk standard and contend there is significant inherent risk in moving from fee-for-service to risk-bearing arrangements, including substantial investment and operational costs, as well as misaligned financial incentives between the payment systems.” And, on the design of APMs, MGMA stated, “MACRA does not require a payment model be tested or expanded nationally by CMMI to qualify as an APM. In fact, MACRA created the Physician-Focused Payment Models Technical Advisory Committee (PTAC) to advance innovative physician- and group practice-driven payment models created by providers and practices outside the walls of CMMI. We believe the agency should give substantial deference to PTAC’s recommendations in order to accelerate development of qualifying payment models appropriate for physician practices of all sizes, specialties, and geographic locations.”
  • EHR Certification—MGMA noted in the letter that Office of the National Coordinator for Health Information Technology (ONC) “implemented an EHR certification process that required software vendors to divert research and development resources away from implementing physician-friendly design to meeting seemingly arbitrary government requirements. This regulatory environment has resulted in lost productivity and additional cost associated with the current certified EHR technology and the negative impact these systems can have on their interactions with patients.” It then stated that because true interoperability has yet to be achieved, “We believe ONC should delay any requirement to move to the 2015 CEHRT requirements and provide greater flexibility in the certification standards to match the health information technology needs of physician practices.”

The letter also included an attached addendum with improvements MGMA think will simplify healthcare and reduce the amount of burdens on providers, including eliminating Meaningful Use Stage 3 and making future CMMI demonstration projects voluntary, as well as much more.

Meanwhile, Health IT Now Executive Director Robert Horne released a similar statement on Price’s confirmation that read, “Dr. Price’s confirmation as Secretary of Health and Human Services provides a unique opportunity for health IT issues. At a time when the Meaningful Use program is anything but meaningful for patients and providers, Dr. Price has an opportunity to rethink how the federal agencies should support healthcare. We hope that Secretary Price uses his authority to make the Meaningful Use program less onerous on providers and IT vendors so that better products reach patients faster. We also hope that Secretary Price scales back some of the actions taken by the Office of the National Coordinator for Health Information Technology (ONC) during the last administration, specifically the Enhanced Oversight and Accountability final rule.”

It should be noted that as a Congressman, Price has previously been active in pressing the Administration and its colleagues to provide more regulatory relief for physicians, which falls right in line with some of these industry associations’ wishes. To this end, he has worked on bills that would reduce the Meaningful Use reporting burdens on physicians and that would make it easier to apply for hardship exemptions. Price reiterated these desires in recent Senate hearings, noting once that physicians “are leaving the practice, not because they have grown tired of it but the onerous nature of the regulatory scheme coming out of Washington, D.C. Meaningful use has turned physicians into data entry clerks,” he said.

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