New $840 Million Grant for Doctors to Improve Healthcare, but is Health IT ready?

By Bill Bunker, Executive Vice President, SCI Solutions

CMS recently announced a new $840 million initiative to reward health care providers to improve medical care and cut health costs. Aligned with the Affordable Care Act, the new Transforming Clinical Practice Initiative is designed to support 150,000 clinicians over the next four years to redesign how their practices achieve optimal patient outcomes and care coordination. Beyond incentives, this initiative affects the bottom line of medical practices, as insurance reimbursements shift from a fee-for-service to a fee-for-value payment model. But is the technology infrastructure in place to support this healthcare transformation?

Interoperability is Key for Effective Care Coordination

The Practice Transformation Network, one of two networks under this initiative, has caused a stir in the health IT field. Today, care coordination is not effectively supported by electronic medical records since interoperability between vendors does not exist. This network focuses on how medical communities can strengthen their relationships between practices, as well as their data sharing capabilities. According to the CMS application in Figure 4B, the milestones for care coordination for specialists contain the following criteria:

  • Practice routinely exchanges essential health information (electronically or otherwise) with other members of the team outside of practice.
  • Develops care coordination agreements with other care providers that cover 50% of their patients and defines co-management responsibilities with other care providers.

While the first part of the measure states this can be met “electronically or otherwise”, many industry professionals argue that we cannot truly improve care coordination if practices remain reliant on antiquated fax machines for exchanging patient information, as the information is not tracked or stored.

Medical Communities Unite for EMR-Agnostic Technology

One way to meet care coordination goals is to connect with others in your medical community on a web-based care coordination platform that is EMR-agnostic. Here at Clarity Health, our web-based platform enables entire medical communities to share patient information, track real-time status, and report on care coordination benchmarks – all regardless of EMR vendor. Many medical communities, such as ACO Franciscan Northwest Physician Health Network, have dramatically improved care coordination between practices using the Clarity platform.

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