Federal policymakers once again are relaxing a technology requirement, this time for a new program, to reflect the healthcare world's struggles to keep up with the latest developments in electronic health-record systems.
This postponement of a previous imposed software deadline deals with a first-time Medicare program to make payments to providers of chronic-care management services. The program covers CCM that extends care to patients outside of a hospital or a doctor's office.
Being able to do that means various EHRs involved need to talk to each other and easily exchange patient information, an aim easier said than done for many providers struggling to keep up with federal EHR mandates.
The change announced last week will allow providers more flexibility about which tested and certified electronic health-record systems they must use to comply. In essence, they can keep using older software rather than upgrading to the latest versions, or they can wait longer for vendors to issue those latest upgrades if they don't exist right now.
The changes were tucked into the 1,185-page final rule on the physician fee schedule covering the Medicare and Medicaid programs released last week by the CMS. Providers can be paid $42.60 a month for “non-face-to-face” care for patients with two or more chronic conditions, it noted.
“We're excited about the chronic-care management codes and the IT portion has some flexibility in it,” said Dr. Robert Wergin, president of the American Academy of Family Physicians, and a family practitioner in Milford, Neb., a town of about 2,000. “We've been doing many of these things in the past, but didn't have the support or infrastructure to do it.”
Specifically, CCM services providers can use either 2011 Edition certified EHRs—on the market since the federal EHR incentive payment program under the American Recovery and Reinvestment Act ramped up in 2011—or the more recently released 2014 Edition software, tested and certified to meet more stringent requirements of Stage 2 of the EHR incentive payment program.
Initially, the program would have required CCM services providers to step up to 2014 Edition software.
For CCM, providers must use EHRs to create a “structured recording” of a chronically ill patient's “demographics, problems, medications, medication allergies, and creation of structured clinical summary records,” the CMS has said.
CCM providers also must use an EHR to capture information about a patient's care-management plan. That information must be made available electronically “on a 24/7 basis to all practitioners within the practice” participating in billing for reimbursements for CCM services.
The 24/7 access requirement could prove “problematic,” said Robert Tennant, senior policy adviser for the Medical Group Management Association.
“This is going to take a vendor working with a group practice to make this happen. This isn't something you can cobble together on your own,” Tennant said.
Follow Joseph Conn on Twitter: @MHJConn
