Advanced payment models could drive healthcare tech development, experts say

A senior woman sitting on a yoga mat looks at a smartphone with information about heart rate.
New payment models can drive tech innovation, experts say, if developers can access needed data. (Getty Images/doble-d)

New payment models can drive tech innovation, experts say—that is, if developers can access the data they need to make new tools useful to patients and providers. That was the experience for Kristina Sheridan, who said that she was inspired to jump into healthcare app development after seeing firsthand how hard the system is to navigate for patients. 

Two of Sheridan's children suffered debilitating illness following a Lyme disease diagnosis. Sheridan, a principal investigator for the MITRE Corporation’s Empowering Patients and Providers to Partner for Best Care project who has a background in aerospace engineering, said she “took a step back” from the 30 providers involved in her kids’ cases and compiled their paper records herself into a spreadsheet. 

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From there, she could better monitor trends in different medications and therapies and could also include self-reported data that came from her children, Sheridan said.  

She is now working on an app to extend that data access to patients more broadly, she said. And, she said, policymakers can drive greater use and development to tools like that, starting with payment policies established in the Medicare Access and CHIP Reauthorization Act (MACRA). “Legislation opens the doors to advanced payment models” for this tech, she said. 

Sheridan was one of dozens of speakers at the Healthcare Payment Learning & Action Network’s summit in McLean, Virginia, on Monday.  

Don Rucker, the national coordinator for health information technology at the Department of Health and Human Services, said that part of what makes paying for health IT complicated is the role of third parties in the market, who may have different—or even competing—interests from providers using their technologies and the payers footing the bill. 

Legislators can untangle some of the complexities of pushing for greater tech adoption, but the Trump administration’s rulemaking can also play a role, Rucker said. The Centers for Medicare & Medicaid Services, for example, is issuing “encouraging payment reform” that ties reimbursement to progress in areas like interoperability. 

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Picking away the interoperability problem is key to making these tools valuable to patients, and thus getting them to be active users, said Ryan Howells, principal at Levitt Partners. Doing so through payment is a powerful motivator to promote data-sharing. 

In addition, Rucker said, the 21st Century Cures Act eliminated some of the traditional barriers to data sharing, boosting interoperability, and it also includes price-setting provisions that tie into the new payment approaches. 

HHS is working from fairly broad standards in these areas, for now, Rucker said, to push for more app development. 

“By having generic standards, we hope to empower as many people as possible” to innovate,” he said.