Week 4 Case Studies
slfontenot
Chapter27CaseStudy.pdf
Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA- MIPS-and-APMs.html. Accessed April 16, 2016.
17. Cragun E. The Most Important Details in the SGR Repeal Law. The Advisory Board Company; 2015. https://www.advisory. com/research/health-care-advisory-board/blogs/at-the-helm/ 2015/04/sgr-repeal.
17a. Medicare Access and CHIP Reauthorization Act of 2015.[ Public Law No: 114-10]. https://www.congress.gov/114/plaws/publ10/ PLAW-114publ10.pdf. Accessed August 3, 2016.
18. American Hospital Association. Physician Payment Reform: What is MACRA. http://www.aha.org/advocacy-issues/ physician/index.shtml. Accessed April 16, 2016.
DISCUSSION QUESTIONS
1. Describe how the NwHIN is facilitated by the MU program.
2. List and describe the federal agencies and committees that are responsible for facilitating electronic exchange of health information in the United States.
3. What are the current time periods for the MU program under Medicare and Medicaid, respectively?
4. How do providers avoid payment penalties for failing to satisfy MU requirements?
CASE STUDY
A health system owns and operates a hospital and employs primary care physicians, general surgeons, and oncologists. The hospital purchased a surgical practice in 2012. Part of the purchase of the practice included the purchase of the elec- tronic medical record system that was a certified EHR. In Jan- uary 2014, the hospital transitioned the primary care physicians, surgeons, and the radiologists in the hospital to a new certified electronic health record, the implementation of which was completed 10 months later in October 2014. The physicians did not satisfy the MU criteria from January 1, 2014, to December 31, 2104, because of the transition to a new certified EHR system. In addition, in 2015 the hospital’s electronic medical record vendor informed the hospital that it would not be able to satisfy the Stage 3 interoperability and technology standards by January 2018.
Discussion Questions 1. Determine which (if any) of the following physicians will
be subject to a payment penalty in 2015: (a) primary care physicians, (b) surgeons, or (c) radiologists.
2. Describe the timeline of the program and its potential financial impact on the individual healthcare providers who are involved in MU.
3. Describe the process the physicians must complete to avoid the payment penalties.
4. Describe the time frame for the provider to achieve mod- ified Stage 2 and Stage 3 measures.
5. Discuss what the hospital must do to achieve the MU objectives for interoperability.
473CHAPTER 27 The Health Information Technology for Education and Clinical Health Act
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