a new incentive program, many states still allowed providers to participate and receive incentive funds. Meaningful Use requires that eligible professionals “adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.” (CRISP Health, n.d.) For many providers, this incentive payment allowed them the ability to afford purchasing certified software. Even though meaningful use was discontinued at the federal level through the Medicare program, it was replaced by the MIPS program. MIPS stands for Merit-based Incentive Payment System and this program still exists nationally. Through MIPS, performance is measured through the data clinicians in four areas. Those four areas include quality, improvement activities, promoting interoperability and cost. “We designed MIPS to update and consolidate previous programs, including: Medicare Electronic Health Records (EHR) Incentive Program for Eligible Clinicians, Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VBM). (Centers for Medicare and Medicaid Services, n.d.) MIPS is a move toward value-based healthcare. Many of the quality measures look at a proactive healthcare approach, which includes things such as tobacco cessation and diet and exercise education. These are covered under MIPS and show a proactive approach is needed to make the move for value-based care. The quality program evaluates the care delivered by the provider using metrics created by Centers for Medicare and Medicaid Services (CMS). Measure subsets
Quality Improvement in Healthcare 16 are defined by provider specialty type. A provider can choose any six metrics that best fit their practice, regardless of type. Once the provider submits their measures, CMS compares scores against their peers nationally. Providers who rate well may receive an incentive payment. However, a provider who either does not participate or who performs poorly may receive a negative payment adjustment. “MIPS was designed to tie payments to quality and cost efficient care, drive improvement in care processes and health outcomes, increase the use of healthcare information, and reduce the cost of care.” (Centers for Medicare and Medicaid Services, n.d.) At one time, reactive healthcare was the normal practice. We have seen that most new thinking is to combine proactive healthcare in order to be most effective. “There are six aims for improvement, noting that healthcare should be safe, effective, patient- centered, timely, efficient, and equitable.” (Ulrich & Kear, 2014) All practices should be implementing quality improvement processes to improve the quality of healthcare. The six aims for improvement are not able to be improved by only using a reactive healthcare approach. It will take a proactive approach by physicians, nurses, managers and the patient for a true improvement in quality to be realized.
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