A rising number of physicians would switch their contracts to a different hospice provider if the organization had an electronic health record (EHR) that is interoperable with their own. Likewise, hospices and other post-acute providers are increasingly recognizing the importance of achieving interoperability with their referral partners. 

Nearly 75% of physicians indicated in a MatrixCare survey that they would be apt to change post-acute partners that they believe could more effectively process electronic referrals. This is up from 64% in a similar survey last year. This research also shows that 95% of respondents in the post-acute space believed that interoperability was important to their referral partners, a substantial increase from 34% in last year’s report.

“There’s a general uptick in how much referring physicians care about interoperability with post-acute,” Nick Knowlton, vice president of strategic initiatives at MatrixCare, told Hospice News. “In the hospice and palliative world, the need is growing. The referral sources are even more willing to take a hard look at who they can interoperate with efficiently when they choose post-acute care providers, including hospice providers.” 

Electronic health record (EHR) interoperability is becoming a priority for hospice providers as they prepare for value-based care programs coming in 2021 such as the Primary Cares Serious Illness Population Model and direct contracting. The U.S. Centers for Medicare & Medicaid Services (CMS) requires health care organizations that participate in the models to use certified EHR technology (CEHRT).

CMS recently delayed the Serious Illness Population model from its April 1 implementation date. Thus far the agency has not announced a new start date. Direct contracting is still slated for an April launch.

CEHRT are IT products that comply with criteria established by CMS for certain programs, such as the Merit-Based Incentive Payment System. The Office of the National Coordinator (ONC) maintains the standards, which exist in multiple editions. Providers would have to comply with the 2015 edition for Primary Care First.

CMS applied the ONC certification stipulation because the Medicare Access and CHIP Reauthorization Act of 2015 requires CEHRT for any advanced alternative payment model.

“The key for a lot of value-based reimbursement models would be that you always have to think about quarterbacking the care for the patient,” Knowlton said. “The more data you have in a timely manner — and the better that data is —  the better resolution you can give clinicians and other care providers, and the better you drive success in any value-based reimbursement program.”

Interoperable technology is designed in part to improve care coordination. Definitions of interoperability can vary, but the term most often refers to the ability of different IT systems and software applications to communicate, exchange data and use the information that has been exchanged.

CMS and ONC developed the interoperability rules pursuant to provisions of the 21st Century Cures Act, passed by Congress in 2016. This requires public and private organizations to share health information between patients and other parties while ensuring the privacy and security of those data.

Among other findings, the MatricCare survey found that more than 58% post-acute providers believe that EHC interoperability has made progress during the past 12 months, but that more work needs to be done to further develop those systems further.

“[interoperability] is happening today, and agencies can participate in it,” Knowlton said. “In terms of the level of maturity, we do see a lot of opportunities for advancement. “Hospice fits neatly within the post acute continuum for the opportunities to connect and the opportunities to become more sophisticated in how we connect.”





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