Impacts of meaningful use and what's next: The Next Generation Accountable Care Organization model

摘要

In 2009, with the passage of the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), the federal government authorized twenty-one billion dollars to launch the Meaningful Use program. The goal was to encourage healthcare providers to use electronic health record systems, and thereby facilitate electronic information sharing among healthcare providers, patients, and clinical data registries. The Meaningful Use program succeeded in promoting adoption of electronic health record systems - at considerable cost and with mixed results. In April 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law by President Obama. Under provisions of MACRA, Medicare reimbursements to health care providers will be based on demonstrable improvements in patient outcomes and reduced health costs, and not for the use of electronic health record systems per se. The Centers for Medicare and Medicaid Services recently announced the Meaningful Use program will end in 2016 and will be supplanted by other initiatives, such as the Next Generation Accountable Care Organization (ACO) model. Accountable Care Organizations are composed of doctors, hospitals, and other health care providers and suppliers that voluntarily collaborate to offer coordinated, quality care at lower cost to Medicare patients. This paper discusses impacts of Meaningful Use and why meeting its goals presents formidable challenges. To comply with Meaningful Use, Medicare providers must use a certified EHR system. However, the certification process omits many key considerations critical to operational success, and does not suffice as evidence the EHR system is suitable for a particular clinical setting. Innovative, holistic solutions are needed to improve EHR interoperability, usability, and support for Health Insurance Portability and Accountability Act (HIPAA) compliance.