Policy & Regulation News

How MACRA, MIPS will Help Deliver Patient-Centered Care

CMS recently released the MACRA proposed rule, which includes MIPS guidelines that will specifically promote patient-centered care and patient connectivity.

By Sara Heath

- CMS has announced its proposed rule for implementing the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS), which centrally focus on delivering patient-centered care.


According to an April 27 blog post written by CMS’s Andy Slavitt and HHS’s Karen DeSalvo, the proposed rule targets patient-centered care by adding provisions for how providers use their health technology to cater to patient needs and facilitate patient engagement.

Specifically, the proposed rule focuses on promoting connectivity between patients and providers through the use of health technology.

“Today, based on that feedback, we are proposing to incorporate the program in to the Merit-based Payment System (MIPS) in a way that makes it more patient-centric, practice-driven and focused on connectivity,” the pair wrote. “This new program within MIPS is named Advancing Care Information.”

Slavitt and DeSalvo discussed not only the general guidelines of MACRA implementation, but also the way in which certain parts of the law will affect patient engagement and patient-centered care, namely through better data sharing between multiple providers and between providers and their patients.

The patient-centered nature of the law hinges on provisions which call for patient access and exchange of health data through health technologies. Although familiar to some of the patient engagement requirements included in meaningful use, this provision focuses on how interoperability can help boost patient-centered care.

MIPS will “emphasize interoperability, information exchange, and security measures and require patients to access to their health information through of APIs.”

In order to foster this kind of care coordination and patient connectivity, Advancing Care Information includes measures that will reinforce the collection of patient-generated health data, help providers determine best care options for individual cases, and include patients and their families in treatment plans.

As noted in CMS’s proposed rule:

These are measures that reflect the potential to improve patient-centered care and the quality of care delivered to patients. They emphasize the importance of collecting patient-reported data and the ability to impact care at the individual patient level, as well as the population level. These are measures of organizational structures or processes that foster both the inclusion of persons and family members as active members of the health care team and collaborative partnerships with health care providers and provider organizations or can be measures of patient-reported experiences and outcomes that reflect greater involvement of patients and families in decision making, self-care, activation, and understanding of their health condition and its effective management.

The guidelines included in Advancing Care Information will also allow better provider flexibility, giving doctors the chance to deliver the care that will work best for them and their patients individually.

“These improvements should increase providers’ ability to use technology in ways that are more relevant to their needs and the needs of their patients,” Slavitt and DeSalvo noted.

Overall, the MACRA implementation will utilize various different aspects of healthcare – including certain payment incentive programs and new patient-centered care models – to refocus healthcare to specifically target patient-centered care.

“By incentivizing participation in certain APMs, such as Accountable Care Organizations (ACOs), Medical Home Models, and episode payment models, and by incentivizing quality and value for eligible clinicians under the MIPS, we support the nation’s progress toward achieving a patient-centered health care system that delivers better care, smarter spending, and healthier people and communities,” CMS wrote in its proposed rule.

“Ultimately, MIPS should, in concert with other provisions of the Act, support health care that is patient-centered, evidence-based, prevention-oriented, outcome driven, efficient, and equitable,” CMS continued.

According to Slavitt and DeSalvo, CMS determined these action plans by consulting with key industry stakeholders, providers, and patients, in order to best understand the changes necessary to promote patient-centered care.

By honoring the feedback received, the pair say MACRA and the provisions within MIPS will help bring the healthcare industry closer to its overall goal of delivering more patient-centric care, ultimately leading to better care outcomes.

Going forward, Advancing Care Information will affect Medicare payments to physician offices only, and will replace the current meaningful use rule starting in January 2017. CMS is reportedly identifying ways in which the agency can align Advancing Care Information with Medicare hospitals and Medicaid programs.


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