MACRA final rule includes financial incentives for remote monitoring, flexibility on EHR certification

The finalized Quality Payment Program (QPP) rule issued by the Centers for Medicare and Medicaid Services on Thursday maintains its leniency on EHR upgrades for 2018 and includes several new incentives for physicians to use patient-generated data and remote monitoring technology.

The 1,658-page file rule (PDF) codifies 2018 QPP payments, an initiative established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that rewards physicians for value and outcomes.

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The final rule includes reimbursement changes suggested by the App Association’s Connected Health Initiative in February. A new improvement activity performance category, weighted as “high,” rewards physicians that leverage digital tools and devices that collect patient-generated health data including “patient engagement and outcomes tracking platforms, cellular or web-enabled bidirectional systems, and other devices that transmit clinically valid objective and subjective data back to care teams.”

CMS states that devices must use an “active feedback loop” to provide data in real or near-real time. A separate improvement activity category incentivizes providers to use remote monitoring tools like blood glucose logs or home blood pressure monitors fed through a certified EHR.

In an emailed statement to FierceHealthcare, Morgan Reed, the executive director of the Connected Health Initiative, said prior CMS regulations “created serious disincentives for doctors to consider using new technologies,” but the new rule offers an opportunity for innovators to collaborate with physicians.

“These new rules are an important step forward for America’s connected health innovators, doctors, and most importantly patients,” Reed said. “Until now, connected health technologies have been effectively locked out of the most important part of America’s healthcare system, Medicare and Medicaid.”

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As outlined in the draft rule released in June, the finalized updates to QPP in 2018 will allow physicians participating in MIPS to continue using 2014 Edition Certified EHRs, while providing bonus points to practices that upgrade to the 2015 Edition.

“We believe the flexibility to use EHR technology certified to either the 2014 Edition or the 2015 Edition for the Quality Payment Program Year 2 is beneficial as vendors will have additional time to deploy the updated software to their customers, which are the clinicians and other providers,” the rule states. “Clinicians will likewise have additional time to upgrade and implement the new functionalities.”

Groups like the American Medical Informatics Association (AMIA) and the Medical Group Management Association were pleased with the flexibility offered in the draft rule.