Can small practices make it through MACRA? In this podcast, Pam Minichiello of the Massachusetts eHealth Collaborative says it depends on preparation.
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In this edition of the podcast, we are joined by Pam Minichiello, project director at the Massachusetts eHealth Collaborative (MAeHC), a nonprofit organization that provides advisory and health IT-related services to small practices in its region. This includes assistance with implementing and optimizing EHRs, adhering to Patient-Centered Medical Home (PCMH) standards, complying with Meaningful Use and the Physician Quality Reporting System (PQRS), participating in Accountable Care Organizations (ACOs) and Health Information Exchanges (HIEs), and much more.
Minichiello talked with us about the different challenges small practices face with implementing and optimizing tech in a value-based world. She said the biggest challenge, not surprisingly, is a lack of employee resources to manage the EHR and other critical IT systems. "They don't have a database administrator … they usually have someone in the office that does that [work]. Sometimes I've worked with some offices and it's actually the provider doing it. Their updating their own templates when they get time," she said.
Later, she talked about why HIE involvement by small practices has been scarce. In Physicians Practice's recent Tech Survey, only 25 percent of practices said they were in an HIE. She's had some success with getting small practices aboard the HIE in the area she works in and says one strategy is "trying to find out [what their pain points are] and coordinating [to see] if that's in the HIE and how [the practices] can utilize that." She added, "[We] show them that they don't have to have phone calls, they don't have to fax back and forth … showing them how they can coordinate care between those two trading partners."
In terms of implementing the Medicare Access & CHIP Reauthorization Act (MACRA), Minichiello says that it is not impossible for practices to make it through the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) tracks in one piece. Specifically, if they've already begun to go down this path. "[Small practices] will have an upward battle ... but the ones that have already been PCMH-recognized, they have quality initiatives, they're monitoring their performance, they're looking at their patient experience data, they've developed care-management processes, they'll have a leg up," she said.
Lastly, Minichiello has some parting advice for small-practice physicians on the journey from volume to value: "Educate yourself now on these proposed changes, so you can understand what they mean. There is a wealth of information out there, not only from CMS, but there are tons of presentations available … so you can understand this in regular language." From there, she said, take the information you've learned and apply it to your own organization.
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