Over the course of 2014, health care providers experienced a number of struggles in handling the many changes within the health IT world. Alterations to meaningful use standards, ICD-10 delays and changes to multiple attestation deadlines have made it difficult for providers to feel they are on stable ground as they implement electronic health records and strive to meet meaningful use standards.
The American Medical Association recently released its list of the top 10 potential issues providers are likely to face as they take on a new year of health IT changes and updates. The list highlights some of the common complaints seen in the past and brings attention to a couple of new ones that may pop up.
The burden of regulatory initiatives
From potential meaningful use problems to challenges with chronic disease care, the AMA has considered every aspect of health care and the potential dilemmas that may arise. Of the AMA's list, the first point of the 10 took note of the problems that physicians should consider preparing for in regard to the EHR Incentive Programs and the regulatory and administrative requirements that come with it.
EHR Intelligence pointed out that of all the problems providers and hospitals have faced, challenges with regulatory programs and a heavy administrative load have been some of the most challenging. The AMA stressed that these burdens frequently take time away from more important aspects of health care, such as patient care. Meanwhile, the results of dedicating so much time and effort to these initiatives do not have any direct benefits on care delivery or other essential health outcomes that should be focused on more intensely.
Meaningful use standards
The AMA touched on three regulatory initiatives that could be improved this year. The first is the meaningful use standards required in using an EHR system. In 2014, the stage 1 and 2 meaningful use requirements proved to be almost unachievable for physicians, and the AMA has emphasized the need for these to become more flexible in 2015 in order to make them attainable.
Experts have found that not only have the overly strict requirements of the EHR Incentive Programs made it difficult for physicians to meet its standards, but it has also kept the number of participants lower than expected.
"They are hindering participation in the program, forcing physicians to purchase expensive electronic health records with poor usability that disrupts workflow, creates significant frustrations and interferes with patient care, and imposes an administrative burden," said AMA President Elect Steven J. Stack, M.D., in a statement to the Centers for Medicare and Medicaid Services.
The organization is also pushing for a meaningful use program that fits all sizes of practices and hospitals to reduce confusion. It is partnering with physicians, policymakers, health care systems and EHR vendors to promote enhancements to the incentive program in hopes of advancing patient care and health outcomes.
The second initiative the AMA foresees trouble with this year is the long-anticipated ICD-10 implementation. The organization has warned providers that there could very well be disruptions to ICD-10 release, which can have a negative impact on practices that have taken the proper steps to prepare for Oct. 1, forcing them to revert back to the old codes with ICD-9 after learning the updated ones.
However, the CMS has announced multiple times that there will be no more delays, which should encourage providers to familiarize themselves with the new set of codes despite the risk of another setback. The agency has released a set of tools to assist hospitals and providers in better understanding and practicing for the new codes and procedures that should be taken advantage of.
"Given the potential that policymakers may not approve further delays, ICD-10 resources can help physician practices ensure they are prepared for implementation of the new code set," wrote the AMA in this section, according to EHR Intelligence. This mild language is significant, as the AMA has been harsher and more critical about the transition to ICD-10 in the past.
Federal fraud and abuse programs
The third subcategory under the regulatory burdens is federal fraud and abuse programs. Physicians have continued to be unfairly taxed as a result of the efforts from the Medicare recovery audit contractors to prevent fraudulent activity within the Medicare system. The AMA noted that over 60 percent of the RAC's accusations are successfully appealed. This is not including the two years of appeals that the CMS still has to address. With any luck, the CMS will take a close look at the program and make the proper changes this year.
As these three points were only subcategories of the first challenge the AMA predicts for 2015, there were nine other items on the list. A few of these include the struggle to prevent the spread of diabetes and heart disease, the abuse of prescription medications, limited provider networks, the need to adequately modernize the AMA's Code of Medical Ethics and the transformation of medical education.