Fact Sheet: Nursing Informatics-Related Healthcare Policy
Policy or Regulation: The Medicare Access and CHIP Reauthorization Act (MACRA)
Brief Explanation: The Medicare Access and CHIP Reauthorization Act (MACRA) is a healthcare policy enacted in 2015 to reform Medicare payments to healthcare providers. It replaced the Sustainable Growth Rate (SGR) formula, which determined Medicare payments to physicians, with a new system called the Quality Payment Program (QPP). The QPP aims to improve the quality of care and promote value-based care by providing incentives for high-quality care delivery and penalizing providers who do not meet certain performance measures.
Impact on System Implementation: MACRA has impacted the implementation of health information technology (HIT) systems in healthcare organizations. The QPP requires providers to use certified electronic health record (EHR) systems and report data on performance measures. Healthcare organizations must ensure that their HIT systems meet QPP requirements to avoid financial penalties.
Impact on Clinical Care, Patient/Provider Interactions, and Workflow: MACRA has had a significant impact on clinical care, patient/provider interactions, and workflow. Providers must report on quality measures related to patient outcomes, patient experience, care coordination, and patient safety. This incentivizes providers to focus on delivering high-quality, patient-centered care. However, the reporting requirements can also add administrative burden and disrupt workflow.
Organizational Policies and Procedures: Our healthcare organization has implemented several policies and procedures to address MACRA requirements. We have adopted certified EHR systems and trained our staff on how to use them to report quality measures. We have also implemented workflows to ensure that quality measures are reported accurately and timely. Our organization has a quality improvement program that monitors our performance on QPP measures and identifies opportunities for improvement. We believe that these efforts will enable us to deliver high-quality care and improve patient outcomes while complying with MACRA regulations.