- As 2017 draws to a close, healthcare professionals must ready themselves for a new set of patient engagement reporting requirements under both meaningful use and the Medicare Access and CHIP Reauthorization Act (MACRA).
These policy mandates are on the horizon for providers, despite assertions that patient engagement is about more than check-box reporting requirements. Amidst the hustle to implement a positive patient experience, organizations must also ensure they are hitting the basic benchmarks that have shaped patient engagement in the health IT era.
Between Stage 3 Meaningful Use and MACRA protocol, healthcare organizations will have their hands full with reporting requirements. Below, PatientEngagentHIT.com reviews the key reporting elements providers must know for success in the year ahead.
Stage 3 Meaningful Use reporting begins for all
Perhaps one of the bigger changes coming in 2018 is that all eligible hospitals and eligible providers must attest to Stage 3 Meaningful Use. This final installment of the Medicare and Medicaid EHR Incentive Programs began as an option for eligible hospitals and providers in 2017.
Starting in the new year, all participants must attest to Stage 3 Meaningful Use, regardless of when the entity began participating in the programs.
Reporting for Stage 3 Meaningful Use has been condensed to 90 consecutive days for 2018. Eligible hospitals and critical access hospitals (CAHs) must submit meaningful use reporting to the QualityNet Secure Portal (QNet).
The patient engagement requirements involved in Stage 3 Meaningful Use appear to be more streamlined compared to previous iterations of the EHR Incentive Programs. Stage 3 Meaningful Use condenses patient engagement requirements into one overarching rule, per the program’s final rule issued in October 2015.
In the Stage 3 Patient Electronic Access Objective, we proposed to incorporate certain measures and objectives from Stage 2 into a single objective focused on providing patients with timely access to information related to their care. We also proposed to no longer require or allow paper-based methods to be included in the measures (80 FR 16753) and to expand the options through which providers may engage with patients under the EHR Incentive Programs. Specifically, we proposed an additional functionality, known as application programming interfaces (APIs), which would allow providers to enable new functionalities to support data access and patient exchange.
Patient engagement requirements in MIPS
The Merit-Based Incentive Payment System (MIPS) is one path in the Quality Payment Program. Each of these elements fall under the overarching MACRA umbrella, passed in the House of Representatives and Senate with strong bipartisan support in 2015.
In 2018, MIPS will be going into its second year of reporting using the same patient engagement requirements included in the 2016 implementation rule.
Most of the patient engagement reporting requirements fall under the Advancing Care Information category of MIPS, which pertains to the use of certified EHR technology (CEHRT). At the crux of this effort is the priority to better engage patients and support care coordination, CMS said in an executive summary of the rule.
“With these objectives we recognize that the Quality Payment Program provides new opportunities to improve care delivery by supporting and rewarding clinicians as they find new ways to engage patients, families and caregivers and to improve care coordination and population health management,” CMS wrote.
As such, eligible clinicians must demonstrate that they can improve patient engagement and care coordination using health IT. Specifically, eligible clinicians must demonstrate the following:
- Allow one unique patient to view, download, and transmit capabilities with their health data
- Allow one unique patient access to their health data via an application programming interface (API)
- Supply patient-specific educational materials to one unique patient
- Extend one unique patient view, download, and transmit capabilities, with that patient then transmitting the data to a third-party provider
- Send or answer at least one secure direct message with one unique patient
- Collect patient-generated health data from one unique patient
- Send or receive a summary of care from a third-party provider for one unique patient
Participants will still be able to enjoy the flexibilities of the CMS “pick your pace” rule, which allowed participants to choose one of four tracks for MIPS reporting in 2017. In the 2018 final MACRA rule, CMS Administrator Seema Verma stated the participants can still gradually begin MIPS reporting if they are still experiencing barriers to full implementation.
Additionally, the 2018 final rule also established some flexibilities for rural hospitals with less than $90,000 in allowable charges or less than 200 Medicare Part B beneficiaries. These organizations will benefit from low-volume threshold flexibilities.
Although not much has changed since 2017 with regard to healthcare policies and patient engagement reporting requirements, they are still critical for providers. Because of the considerable financial implications of these rules, organizations will benefit from reviewing these patient engagement requirements to ensure compliance and optimal reimbursement rates.