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October 17, 2016 News No Comments

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In case you weren’t aware … CMS publishes the final MACRA rule to mostly positive acclaim. Fun facts about the new rule:

  • It is 2,204 pages.
  • Knowing what a time crunch physicians are already in, HHS has summarized it in 24 pages.
  • HHS Acting Administrator Andy Slavitt has put together his own summary, clocking in at 1,344 words.
  • The department has also created a website to help stakeholders digest it.

In his summary, Slavitt offers consolation to small practices worried about the new, potentially burdensome regulations:

“We know that small practices deliver the same high-quality care as larger ones. Yet at every practice we visited or event we held, we heard from physicians in small and rural practices concerned about the impact of new requirements. We heard these concerns and are taking additional steps to aid small practices, including: reducing the time and cost to participate, excluding more small practices (the new policy will exclude an estimated 380,000 clinicians), increasing the availability of Advanced APMs to small practices, allowing practices to begin participation at their own pace, changing one of the qualifications for participation in Advanced APMs to be practice-based as an alternative to total cost-based, and conducting significant technical support and outreach to small practices using $20 million a year over the next five years, as well as through the Transforming Clinical Practice Initiative. Due to these changes, we estimate that small physicians will have the same level of participation as that of other practice sizes.”


With MGMA kicking off in a few weeks, I thought it was worth reaching out to Anders Gilberg, MGMA’s senior vice president of government affairs, to get a better sense of the association’s reaction (and to see how many session titles might have to be changed in light of the final rule’s mid-October publication).

How would you suggest physician practices begin to digest the final rule?
Look to MGMA and professional specialty societies to distill key elements of the rule, despite the sheer magnitude of the regulation. The 2017 requirements have been significantly scaled back and every physician practice should begin to engage. They should also attend MGMA’s 2016 Annual Conference to participate in the “Under the MACRAscope” series, which breaks down the final rule in three separate conference sessions, as well as a general session on the final day of the conference.

When it comes to healthcare technology, what should a practice’s number-one priority be when it comes to preparing for MACRA?
For physician practices who have yet to participate in Meaningful Use, as well as those who have been successful with MU in the past, they should review the final MIPS EHR requirements to ensure that they can fulfill the all new program requirements. We recommend leveraging MGMA resources, including our online communities and face-to-face conferences, to network with colleagues who have successfully implemented technology and modified workflows to capture and report data. All practices should engage with their EHR vendors to determine the best approach to meeting MIPS and ensure that the vendor plans to recertify to the more robust 2015 CEHRT by 2018.

How will the release of the final rule affect session content and show-floor buzz at the show in a few weeks?
We knew the rule would come out right before this year’s annual conference and have the content tracks already in place to help physician practices begin this journey. Without a doubt, it represents one of the most significant changes to the healthcare payment and delivery system in 20 years. We expect practice executives, vendors, physicians, and virtually everyone at the conference will be talking about it. Both learning the substance of the rule and affirming relationships between practices and their vendor partners will be critical to success. We expect there will be great ideas and solutions on display in the exhibit hall to help practices meet the new program requirements, which take effect in just a few months. 

HIStalk Practice Announcements and Requests


And speaking of MGMA: If you’re a HIStalk Practice, HIStalk, or HIStalk Connect sponsor exhibiting at MGMA, complete this form and I’ll include your company in our downloadable exhibitors guide. Today is pretty much your last chance to submit information, as I’ll be compiling the guide for publication over the next couple of days.


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October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.

November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.

November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates "stickiness," and delivers the expected benefits to everyone involved.

Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Announcements and Implementations


Enjoin releases CDocT, a new CDI training module designed to help physicians transition to value-based payment models. (VP James Fee, MD offered HIStalk Practice readers physician engagement-related tips to improve CDI several weeks ago.)


The American Academy of Ophthalmology announces that its three year-old Intelligent Research in Sight (IRIS) Registry has helped 14,000 physicians keep track of practice patterns and clinical benchmarks for 28 million patients over the course of 100 million office visits, thus making it the “world’s largest clinical database.”


Acuity Eye Specialists (CA) and partner Retina Institute go live with CareCloud’s EHR and PM system across 40 locations.

Acquisitions, Funding, Business, and Stock


Nashville-based Expression Health Analytics raises $315,000 in seed funding from NueCura Partners, which it will no doubt use to hire additional staff and further develop its multi-payer, claims-fueled BI database. The company officially launched last year under the leadership of Dana Goldberg (Market Connection Consulting) and Jeff McDonald (Evariant). Goldberg, who also heads up research and strategy, tells me the startup’s analytics can help steer decisions related to opening new practices in strategic locations, growing business in existing locations, and identifying the best targets for mergers and acquisitions.



Executive search and advisory firm Korn Ferry promotes Jessica Johnson to head of its new Futurestep Healthcare Technology & Services Practice.

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Utah Health Information Network promotes Candace Czerny to COO and welcomes Andrew Burchett as CIO.



TruClinic adds Orca Health’s digital point-of-care and after-care patient education resources to its telemedicine and PM software. TruClinic is currently enrolled in Startupbootcamp’s Miami accelerator, which concludes with a demo day in late November.

Government and Politics

HHS also releases the “ONC Health IT Certification Program: Enhanced Oversight and Accountability” final rule, which gives ONC the power to directly review certified health IT products and take action in the event that such products put the public’s health and safety at risk, and/or present challenges for ONC-Authorized Certification Bodies.



AHIMA is in full swing in Baltimore, offering HIM professionals sessions related to coding, billing, privacy, and security, among others. The #AHIMACon16 tweet stream is filled thus far with pictures from the exhibit hall including sword-swallowers and fun giveaways. I love that AHIMA’s Career Center is offering Bobbi Brown makeovers and headshots. Free show-floor headshots sound good in theory, but the results have left me with the realization that a little freshening up beforehand might have improved things just a bit.

And speaking of coding, the local news covers one practice’s problems with rejected claims due to a processing glitch on the part of Excellus Blue Cross Blue Shield. The payer, which is still updating its systems so that it can accept ICD-10-coded claims, has told physicians to hold such claims until October 19. “I’ve never seen anything come through like this,” says Lori Kiser, business manager at Retina Associates (NY), pointing to a stack of envelopes with correctly coded but rejected claims from Excellus. “In a week, it’s well over $100,000. There should have not been any kind of hiccup here because it means loss revenue for us. We’ll eventually retrieve it, but it’s lost right now.”


JennMr. H, Lorre, Dr. Jayne, Dr. Gregg

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