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Patient Advocates Praise Patient-Centered Efforts in MACRA

The Consumer Partnership for eHealth has submitted comments to CMS praising MACRA for its patient-centered health IT provisions.

- The proposed MACRA rule is “on the right track” toward fostering better patient-centered uses for health IT, according to the National Partnership for Women & Families and the Consumer Partnership for eHealth (CPeH).

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CPeH, which is sponsored by the National Partnership for Women & Families, submitted a comments letter to CMS, praising the many of the patient-centered actions included in the proposed rule for the Medicare and CHIP Reauthorization Act (MACRA), and presenting several suggestions to take those actions a step further.

“Consumers are eager to work with the Centers for Medicare & Medicaid Services (CMS) to leverage health IT and health information exchange to improve the quality and value of care, and ensure that new models of care delivery and payment provide consumers and their family caregivers access to well-coordinated, patient- and family-centered care,” CPeH wrote in its comments.

“Our comments focus on provisions in the proposed rule related to the use of health IT in MIPS and Advanced APMs.”

First, the organization suggested that CMS increase the “one patient” requirement, which states that providers must share health data, e-prescribe, or secure message one patient in order to calculate its score in the Advancing Care Information in the Merit-based Incentives Program (MIPs).

CPeH states that the threshold should be 5 percent of a provider’s patients by 2019 in order to further advance CMS’s efforts to provide patient-centered healthcare through technology.

“Keeping the ‘one patient’ threshold – and broadening its application to all measures (not just View/Download/Transmit and Secure Messaging) – undermine CMS’s commitment to make patients and family caregivers true and equal partners in improving health through shared information and shared decision-making,” the organization said.

CPeH praised the rest of the performance score, however, lauding CMS’s efforts for patient and family engagement through care coordination and health information exchange (HIE).

The agency also had a handful of other suggestions for CMS, most of which center on enabling health data sharing with patients and families, and refining definitions for both certified EHR technology and meaningful use.

  • Improve the structure and reporting of Clinical Practice Improvement Activities (CPIA) and add activities that leverage health IT in new and innovative ways.
  • Add a single, more robust shared care planning CPIA that leverages the information and activities patients and families want and need to help with their care.
  • Add key functionalities to the definition of Certified EHR Technology (CEHRT), including incorporation of social, psychological and behavioral data; care plans; and accessibility-centered requirements.
  • Help clinicians new to using health IT fulfill the requirements within the ACI category and provide timely feedback on how all clinicians are fulfilling relevant measures.
  • Retain a robust definition of “Meaningful User.”
  • Retain the proposal to prevent information blocking, and enforce patients’ timely access to and use of their electronic health information, since patients too often face obstacles to accessing and using their health data.

According to CPeH leaders, it is important for CMS to create provisions within MACRA that improve patient-centered care, specifically given the law’s potential to shape the overall healthcare industry and improve healthcare spending.

“Health IT can help patients and caregivers make better informed decisions; connect with health care providers; generate and share important health information; and set, track and achieve personal health and wellness goals,” said Debra L. Ness, the president of the National Partnership for Women & Families, in a press release.

“To achieve this, CMS must set strong requirements that ensure person-centered health IT is fully integrated into new models of health care delivery and payment,” she continued. “The proposed rule is on the right track, and changes like those we recommend will improve its ability to truly transform care and enhance the overall health of patients.”

Going forward, CMS should strengthen MACRA to better build trust between patients and providers, and facilitate better sharing and communication between the two parties, CPeH concluded. Ultimately, such relationships should lead to better health outcomes and a more efficient healthcare system.

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