Officials from the American Medical Informatics Association (AMIA) are urging the U.S. Centers for Medicare and Medicaid Services (CMS) to use new payment policies to reassess how providers are required to use informatics tools, and to rethink how quality is measured in a digital world.
In submitted comments, AMIA said new and novel ways to deliver care will rely on dynamic uses of information technology and other informatics tools, so government policies dictating the use of IT should be flexible and evolve as more experience is gained with new care models.
The merit-based incentive payment system and alternative payment models will replace the current fee-for-service payment model for Medicare starting in 2017. This system of reimbursement will rely heavily on electronically specified clinical quality measures to pay physicians based on how well their patients recover, rather than the number of services delivered.
In comments, AMIA said it supported this move to value-based reimbursement, but it voiced concern with the industry's ability to generate accurate and complete electronically specified clinical quality measures, and urged more focus on outcomes-oriented quality measurement.
AMIA wants officials to devote more resources to testing both the accuracy of the measure calculation, as well as the feasibility of the data collection requirements, and pilot new electronically specified clinical quality measures before their release for use. CMS should also establish a regular schedule of updates and revisions to electronically specified clinical quality measures, ensuring adequate time is allowed for implementation of revisions by both the vendor and provider. Further, AMIA suggested that these policies create new opportunities to develop better outcome measures, rather than relying on current process measures.
AMIA further recommends that federal officials avoid overly prescriptive requirements to determine how providers use informatics tools within alternative payment models, but rather focus on the outcomes sought by the use of such tools.
