Among other provisions, the Medicare Access and CHIP Reauthorization Act (MACRA) dramatically changed the methodology for Medicare payments for health care services.
Three of those changes included:
- Ending the Sustainable Growth Rate (SGR) formula;
- Creating a new framework to reward care providers for better health care services; and
- Combining pre-existing quality reporting programs into a single, new system.
Please choose one of the above changes, explain it, and analyze its interaction with health information technology and informatics.
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA), is well known as the law that authorized the funded federal incentives for “Meaningful Use” of electronic health record (EHR) systems in the Medicare and Medicaid programs.
The broader aim of HITECH, however, was to promote electronic movement and use of health information among organizations using nationally recognized interoperability standards, which remains a national challenge. While not as well-known as the EHR incentive payments, HITECH also authorized $564 million in funding to the Office of the National Coordinator for Health Information Technology (ONC) in the U.S. Department of Health and Human Services (HHS), with the goal of facilitating the development of nationwide health information exchange (HIE).
The State HIE Cooperative Agreement Program was created to achieve this goal through state-level solutions. Organizations in all 56 states and territories received funding and ongoing ONC guidance for development and implementation of their plans during the four-year program.
NORC at the University of Chicago evaluated the program in the March 2016 report
included in this week’s reading materials. The NORC report concludes that the HITECH funding created and expanded HIE in terms of services infrastructure as well as supporting legal, and policy structures. While none of the state HIE strategies presented a cookie-cutter solution, certain common factors favorably impact HIE development.
In the interests of sharing a path forward for future HIE grantees, state and federal policy makers, and other stakeholders tasked with continuing HIE development and interoperability, what lessons learned from the NORC report would you bring to their attention?
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