HITECHNow that HITECH reporting structures are in use by many EPs and EHs to secure Meaningful Use (MU) incentive payments, it's time for the healthcare community to look at these infrastructures in a new light. In my conversations with healthcare leaders, I find that many are not thinking past MU incentive payments. Healthcare organizations (HCONs) now need to realize the next step in the HITECH progression: quality reporting is here to stay.

The HITECH Act of the American Recovery and Reinvestment Act funded the development of an infrastructure of standards for electronic medical records (EMRs) and the reporting of clinical quality based on data extracted from them. MU incentives generated stimulus for providers to become early adopters of the infrastructure which will eventually support most reporting requirements for Medicare and Medicaid payment programs. Since providers know that the MU program has an end-date, they may mistakenly consider MU requirements as an optional and incidental burden on their busy plates. What they must remember, however, is that although MU incentive payments will go away, the requirement to report electronic quality measures is only expected to grow.

Consolidated quality reporting is next

Moving forward, MU is not just about incentives. Quality measurement is critical to reforming our nation's healthcare delivery and payment systems and is essential to improving the care provided to individuals and populations while controlling costs. With MU fueling growth in health IT adoption and the retooling of existing measures into electronic clinical quality measures (eCQMs), there is a new focus on the widespread adoption of an infrastructure to support expanded, automated measurement that is, in theory, a by-product of the patient-care process.1

This CMS vision for quality measurement is to align program measures whenever possible, including the public and private sectors. This alignment will allow measures for one program, such as MU, to count toward another, such as the Physician Quality Reporting System (PQRS).

CMS Quality Reporting and Performance Programs
Hospital QualityPhysician Quality ReportingPAC and Otder Setting Quality ReportingPayment Model ReportingPopulation Quality Reporting
  • For hospitals, reporting alignment primarily includes the Inpatient Quality Reporting Program (IQR), Hospital Value-Based Purchasing (HVBP), and the EHR incentive program for Meaningful Use.
  • For physicians and other eligible professionals, alignment between Physician Quality Reporting System (PQRS), Physician Value Modifier (PVM), Accountable Care Organizations (ACO) and EHR Incentive Program for Meaningful Use will apply.

CMS goals for the 2014 reporting period will allow Eligible Hospitals, Eligible Professionals and ACOs to report once and meet the requirements of these programs.

The Time is Now

HITECH Stop Watch

I hope you're beginning to realize that HITECH infrastructures contain many elements needed for quality reporting, along with the value of data that can be applied to different requirements. Is your organization considering how to leverage HITECH data to reduce the burden on your quality reporting staff? Are you evaluating how to facilitate core reimbursement requirements? Should you consider additional analytics to meet quality reporting demands?

Waiting too long to prepare may be costly. I encourage HCONs and providers to examine their reporting resources, leverage existing infrastructures, and obtain outside help as needed to gain efficiency and demonstrate success to meet key performance thresholds such as ED throughput and controlling high blood pressure.

Quality measures can no longer be separated from financial measures – combined, they measure the value of the care you deliver. Moving forward, your reporting infrastructure can illuminate the value of the programs you provide. When MU is gone, will you be ready to leverage your HITECH foundation and deliver effective, affordable, patient-centered care?

1 Anderson, K. M., Marsh, C. A., Flemming, A. C., Isenstein, H., & Reynolds, J. (July 2012). Quality Measurement Enabled by Health IT: Overview, Possibilities, and Challenges (Prepared by Booz Allen Hamilton, under Contract No. HHSA290200900024I.). AHRQ Publication No. 12-0061-EF. Rockville, MD: Agency for Healthcare Research and Quality.

Maggie Lohnes

About the author

Maggie Lohnes, R.N., oversees strategy development and execution for clinical quality measurement initiatives within the McKesson Corporation’s Strategic Intelligence business unit and works to ensure regulatory program compliance for McKesson’s quality reporting products.