News Feature | October 26, 2016

MACRA Brings New Challenges For Smaller HIT Vendors

By Megan Williams, contributing writer

‘Unencrypted Loss’ Breach Level In Healthcare Drops 20 Percent

Smaller EHR vendors might end up in a pinch because of certification requirements around MACRA.

According to the final MACRA rule, beginning in 2018 physicians will no longer be authorized to use EHR technology that is certified for 2014 and will instead have to switch to tech solutions certified for 2015. This impacts the vast majority of providers because, as of July, more than 75 percent of providers participating in the Medicare EHR Incentive Program were using 2014-certified edition technology according to ONC.

For larger vendors, this might not be too challenging an issue. However, for smaller vendors, meeting the requirements could be problematic. According to Corinne Proctor Boudreau, Meditech’s senior manager of marketing for physician experience, “You have seen some of those smaller vendors not be able to make those requirements. But this is the direction the industry has been going in. It's a little bit the cost of doing business. This situation is unfortunate for providers who have invested in an EHR that does not acclimate to agile change at scale.”

The Final Rule
MACRA’s final rule generally expands exemptions and provides more flexibility for providers, largely by letting up on some of the data-reporting requirements. One of the biggest critiques though, is how these changes end up impacting smaller vendors in terms of certification requirements.

The final MACRA (Medicare Access and CHIP Reauthorization Act) rule serves as a sunsetting for payment adjustments under the EHR incentive program. However, a few parts of the program have found new life under MIPS (Merit-based Incentive Payment System). MACRA requires physicians serve as participants in either the MIPS or advanced alternative payment models payment tracks.

Under MIPS, physicians are paid based on success in the following, four payment categories: Quality, Cost (not counted in the 2017 reporting period), Clinical Practice Improvement, and Advancing Care Information (the replacement for the MU program).

Providers that fall under the alternative payment models track will be exempt from MIPS reporting, however they will be required to use certified EHR technology which is where things get tricky for smaller vendors, possibly even leaving providers in a bind since MACRA doesn’t require vendors update their technology.

Leaders in the industry have taken note of the issue, including Robert Tennant, director of health information policy for the Medical Group Management Association who said, “For them to require that level of certification when there's absolutely no indication of how many vendors will be moving in that direction is a little bit irresponsible.” 

Tennant and his group plan on making the case to CMS for providers to be permitted to continue using 2014-certified EHRs. Read more on this issue at Modern Healthcare.

Going Deeper
Get tips on selling MACRA technology to smaller practices here.