Hayes' Healthcare Blog

MACRA 101: 9 Things You Need To Know

Posted by Don Michaels, Ph.D. on June 29, 2016 at 9:00 AM

Congressional passage of the Medicare Access and CHIP Reauthorization Act (MACRA) last year was only the beginning of a major upheaval in Medicare reimbursements. This past April the other shoe fell – all 962 pages of it. The Centers for Medicare & Medicaid Services (CMS) released the Notice of Proposed Rulemaking (NPRM) providing the details on the plan to transition healthcare providers from a payment system based on volume to one that rewards value. MACRA is the next step in driving healthcare organizations from a fee-for-service to a value-based care reimbursement model.

The massive NPRM document will be dissected and discussed (and maybe even read) for many months to come, but the implications for clinicians providing care under Medicare Part B are real and far-reaching. The major consequence for those of you who are Medicare providers is that you will soon have to choose to operate under a merit-based incentive program or transition to an Alternative Payment Model. Other than leaving the practice of medicine, there is no third choice.

Here are nine things you need to know to help you begin digesting this next significant change in the healthcare industry.

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Topics: cms, meaningful use, value-based care, MACRA

8 Things About Healthcare Analytics That May Surprise You, Part 2 of 2

Posted by Lisa English on June 22, 2016 at 9:00 AM

In last week’s post, Lisa English described the growing importance of healthcare analytics in dealing with large-scale initiatives like population health. She also outlined the important role analytics can play in solving the day-to-day problems of monitoring risk areas, supporting continuous risk assessment, and complementing limited compliance resources that organizations face every day.

In spite of the increased reliance on analytics, Lisa stressed that there is still much we need to learn. She outlined four things about analytics that might surprise you. Here are four more considerations surrounding analytics that you may not have realized.

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Topics: mdaudit, Healthcare Analytics, risk management

8 Things About Healthcare Analytics That May Surprise You, Part 1 of 2

Posted by Lisa English on June 15, 2016 at 10:00 AM

Yes, the terms “big data” and “analytics” are buzzwords, but they clearly highlight a shift toward data-driven decision-making with a real measurable impact on outcomes in many different industries. Savvy digital marketers now mine your digital breadcrumb trail to offer you more of what you like and attempt to discern what you need before you are aware of it yourself. This not only drives sales, but also actually helps consumers - if they aren’t “creeped out” by the “Big Brother is watching” when you post on social media then immediately see ads pick up on a word from your post. 

In the healthcare industry, the move to population health is just one obvious application for sophisticated analytics. As we appropriately engage our best and brightest in solving the core healthcare issues of our society, we find the key questions that analytics can help answer: What treatments drive positive health outcomes for patients? How can we curb wasteful, ineffective healthcare? Ultimately, why does the US spend more on healthcare than all developed nations while getting only mediocre healthcare outcomes when looking at our population as a whole?

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Topics: mdaudit, Healthcare Analytics, risk management

How Do We Level the HIT Playing Field?

Posted by Roger Davis, President and CEO of T-System on June 8, 2016 at 9:00 AM

“We are deadly serious about interoperability.”
-Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) at the J. P. Morgan Healthcare Conference in San Francisco in January 2016.

For those of us in the healthcare vendor community, that defining statement sets the tone for the future interaction between organizations. Slavitt was also clear that achieving interoperability means “leveling the technology playing field” and requiring vendors to interchange data. He discussed open Application Programming Interfaces (APIs) as a specific model for integrating and moving data seamlessly between technologies. These are now guiding principles as we collectively try to benefit more from interactions outside our specific verticals.

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Topics: interoperability, cms, HIT, Hayes Thought Leadership Blog Series

4 Tips on How to Involve Your Subject Matter Experts in Your EHR Implementation

Posted by Susam Vang on June 1, 2016 at 9:49 AM

If implementing an electronic health record (EHR) is not already challenging for most healthcare organizations, an EHR system design and implementation’s success or failure is greatly dependent on its stakeholders and subject matter experts (SMEs). A SME is an expert in a particular area or topic. They are the primary intended users – people who will be making decisions on the basis of the workflow analysis, system design, and are a key group of stakeholders. SMEs are important to not only assisting in the system’s development and implementation but also in maintaining the long-term use and effectiveness of the system within an organization.

Striking a balance between the information technology (IT) department and departmental autonomy may be even more of a challenge. Even more so is to effectively augment and involve SMEs, all while keeping everyone happy. The challenge may turn out to be a very difficult one if your SMEs prove to be resistent to change. Based on my past experiences, I have written down four ways to win over SMEs in order to implement an EHR project successfully.

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Topics: subject matter experts, ehr installation tips, healthcare IT project management

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