Assignment: Policy/Regulation Fact Sheet

Policy/ Regulation Fact sheet

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Affiliation

Date

Medicare Access and CHIP Reauthorization Act (MACRA)

Briefly and generally explain the policy or regulation you selected.

Health informatics focuses on information systems, informatics and information technology as they are used for continuity of healthcare delivery. Medicare Access and CHIP Reauthorization Act (MACRA) was adopted in 2015 but enforced in 2018. MACRA started to promote EMR. It is American healthcare regulation that provides a new outline for compensating clinicians who effectively establish value over volume in patient care. It was enforced with the collaboration of HHs and CMS. MACRA offer new tools to provide best possible health care. The best thing of MACRA is its flexibility; participant can practice it according to location, size and population. There are two tracks for MACRA.

Advanced Alternative Payment Models (APMs)

The Merit-based Incentive Payment System (MIPS) (Health IT Legislation,2018)

Impact of the policy

Since its establishment, CHIP has shown positive effects in all aspects and has been successful. It is evaluated that it is. Achieved results of activities to promote MACRA participation. The household participation rate of children in the household has increased. In addition, the use of MACRA services has increased. In addition, the economic burden on medical expenses for low-income people has been reduced. MACRA is economical for low-income people. It is a safety net for medical insurance in difficult times, and CHIP Awareness is high, and the residual rate after joining CHIP is also high (Laws & Regulations,2019)

Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

MACRA revokes the Sustainable Growth Rate (SGR) Plan that has determined Medicare Part B reimbursement rates for physicians and replaces it with new ways of paying for care. That formula had formerly been used by the Centers for Medicare and Medicaid Services (CMS) to control outlay by Medicare on health services. The SGR method was applied to guarantee that the annual rise in the cost per Medicare receiver did not overdo that year’s gross domestic product (GDP) development. Through MACRA, Medicare doctor recompence is no more tied to economic growth; relatively, the compensation formula below MACRA emphases on quality care. Patient outcome measures are demarcated as modification in heath for individuals, groups ,etc. The result of this measure may be in form of death, readmission, and patient experience measures etc.

Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Centers for Medicare & amp; Medicaid Services (CMS) saw a sharp drop in the number of physicians and other clinicians retiring from Medicare participation in 2017.Whether it's an indication of more doctors want to stay in Medicare or as a result of a change in the opt-out process remains to be seen. "The numbers for 2015 and 2016 could represent the first wave of doctors who are withdrawing. The lower 2017 data may reflect the fact that physicians no longer need to produce affidavits to renew, "he said. (CMS data)

One theory that explains why the numbers have decreased is that under the Medicare Access Act and MACRA, suppliers no longer have to submit an affidavit of refusal. every two years. Now, once the doctors withdraw, it's indefinite unless they decide to join the program. Nevertheless, according to CMS data, the number of dropouts dropped to 3,732 in 2017. Doctors and clinicians who do not want to participate in Medicare sign an affidavit that prevents them from seeing beneficiaries submit their bills to CMS . The number of opt-outs was 3,500 in 2015 and 7,400 in 2016. Health informatics is a new and emerging profession. Delivery is responsible for the collection, storage of confidential medical data, the demand for skilled individuals to quickly hit the national supplement.

References

Laws & Regulations. Retrieve from: https://www.hhs.gov/regulations/index.html

Advanced Payment Models.(2019). Retrieve from: https://www.aanp.org/practice/practice-

management/quality-improvement/macra-mips

Health IT Legislation; 21st Century Cures Act( 2018).Retrieve from:

https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation