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MACRA Patient Engagement Cheat Sheet #2

Mark Heaney is the chief strategist and founding partner of Get Real Health, a Rockville, Maryland-based health information technology (IT) company. Heaney has created award-winning software designs, including Get Real Health's instantPHR product, which is now deployed in health organizations worldwide. Prior to founding Get Real Health, he was the vice president of architecture and development at USWEB. During his career, he has spoken at numerous international forums, and has testified on Capitol Hill on the topic of health IT.
Cost/Resource Use Category
This category is unique in that a provider’s score is automatically calculated from CMS claims data. Rather than targeting specific measures, providers are incentivized to improve overall cost efficiency. In general, this means reducing preventable healthcare costs. One of the most effective ways to use patient engagement to achieve this goal is to provide the most expensive patients (those with multiple chronic conditions) with tools to manage their conditions between visits.
At first glance it may seem that the sickest (and therefore most costly) patients aren’t always capable of using at-home technology for self-management. This is true, but patient engagement takes many forms, not all of which require active involvement of the patient. Examples include: a patient’s family member using technology to manage the patient’s conditions, an automatic device that reports data (and can trigger an alert) with minimal patient involvement, or simply providing patients with a daily reminder to take their medication.

Clinical Practice Improvement Activities (CPIA) Category

Similar to the Quality category, CPIA offers providers a long list of measures and lets them choose which ones make the most sense for their patient population. Some of these measures, specifically around population management, are perfect candidates for patient engagement. Simply quoting from a few of them should make the connection to patient engagement obvious:
“Proactively manage chronic and preventive care… Use reminders and outreach to alert and educate patients about services due”
“Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.”

Advancing Care Information (ACI) Category

The ACI category replaces the Medicare EHR Incentive Program (also known as “Meaningful Use”). Patient engagement is necessary to meet the requirements for patient education, patients’ electronic access to their records, and the ability to securely message their providers. If your patient engagement platform is a Certified EHR Technology, it will make reporting easier and can earn you additional bonus points in this category.Plus, advanced patient engagement platforms can help you collect and report additional metrics, further increasing your score and potential financial bonuses.           


A well-considered patient engagement strategy can help you meet your MIPS requirements while providing better care for your patients. All of this can be accomplished without changing your protocols or procedures and with minimal impact on your operations and workflow.
Finally, consider how the practice adjustments you make for MIPS will help (or not help) you meet other industry changes. According to David Katz, executive director of the Advisory Board Company, the forces of consumerism and activated employers will have a far more profound impact on provider business than will MACRA. Highly active consumers and employers are certain to demand an unprecedented level of patient engagement. Therefore, investing in these technologies for MACRA will position you and your organization for the next big wave of change.


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