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Oh My MACRA: Digital Technology’s Role in Value-Based Care



Healthcare Reform with MACRA

Reform is coming to healthcare in 2019—starting with reimbursing high-performing clinicians on the quality of patient care and improving patient outcomes. By 2019, the Department of Health’s new Medicare Access and CHIP Reauthorization Act (MACRA) and the associated Quality Repayment Program will be in full effect. With this new shift in Medicare, effective doctors win and patients get better sooner.

This means that healthcare professionals will need to transition from a fee-for-service model to pay-for-performance and value-based care initiatives in order to avoid MACRA penalties and inadvertently cause financial strain on their practice. In other words, hospitals will get reimbursed based on the outcome of the patient and quality of care versus being reimbursed on providing more treatments or the quantity of care.

One of the major provisions of MACRA is the Quality Payment Program which offers Medicare physicians, nurses and other clinicians two options for value-based reimbursement: Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payments Models (APMs). The program reimburses clinicians based on cost, quality, technology advancement, and clinical improvement measures. With the quality performance category driving 45% of the MIPS scoring criteria, it is crucial that healthcare practices evaluate technology being used to drive patient outcomes and meet the new MACRA requirements.

Digital technology applications and integrations will have a major impact on value-based care with the new reimbursement program. EHR use is at the center of the Quality Payment Program with both MIPS and APMs requiring the use of certified EHR technology to qualify for positive Medicare reimbursement. Technologies integrated with the EHR will help physicians make better and faster patient diagnoses while also connecting other physician networks in order to process referrals and sending prescriptions to pharmacies.

“Under the MACRA propose rule, EHR technology must meet the 2015 Edition Health IT Certification in coming years, which places strong emphasis on the use of application programming interfaces (APIs) to ensure secondary and tertiary uses of clinical health data,” states EHR Intelligence. Healthcare organizations that haven’t implemented integrations within their EMR to automate business processes should consider the significant impact on quality care that can be made by faster patient diagnosis and the greater availability of clinicians thanks to time savings.

If you’re ready to ramp-up your organization’s EHR technology for greater reimbursements, consider investing in solutions that engage patients after they leave a facility, strengthen care coordination efforts, and enhance the patient caregiver relationship to improve patient care. How can Biscom solutions help? The company’s document transmission solutions help provide the best patient experience possible, while giving back more time to the caregiver.

Biscom has always served a large number of healthcare organizations, including some of the most well-known medical facilities in the country. One of the many ways Biscom has made patient communications efficient is by partnering with these hospitals to address the challenges of faxing from Epic, one of the ubiquitous EMRs currently in use. By simplifying the troubleshooting of failed faxes, searching historical faxes, and offering monitoring into the system we’ve made faxing from Epic simpler than ever before.

Not only does Biscom provide the most comprehensive fax EHR integration in healthcare, but offers organizations a full suite of customizable solutions that scale to their health system’s specific needs. The company’s fax and secure file transfer solutions make caregiver and patient communication efficient, increase audibility and reporting, and provide reliable, secure document transmission. Biscom’s mission has always been to improve patient care by saving caregivers time. Now Biscom solutions can also help hospitals increase their reimbursement and make sure patient outcomes are positive.

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