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Simplifying healthcare reform: The known and the unknown

By Chris Emper

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The healthcare industry stepped into 2017 with a sense of unease—and understandably so. In addition to the usual list of issues that challenge healthcare organizations, this year President Trump’s pledge to repeal and replace the Affordable Care Act (ACA) and the start of the first MACRA performance period following last October’s 2,000 plus page final rule have sparked questions from every corner of the industry. How quickly will any changes stemming from the ACA repeal start taking place? What impact will those changes have on patient access and provider patient populations? Where is the industry headed in terms of payment reform?

Do these sound familiar? You’re not alone in your uncertainty.

While the answers to some of these questions may not surface for a while, there is one certainty providers can bank on: the broader shift to value-based reimbursement is here to stay.

What do we know is certain?

Amidst the uncertainty surrounding the ACA, there have yet to be any serious discussions about making fundamental changes to MACRA. The reason? Despite, its flaws and limitations, the MACRA law was a bipartisan effort more than a decade in the making that itself represents the unsustainability of the fee-for-service payment system. Furthermore, MACRA is just one component of the industry's shift towards value, which is being driven by both government and market forces. As such, providers must continue to align their 2017 priorities to enable success under MACRA's new Quality Payment Program, including making critical assessments of existing technology infrastructure and detailed evaluations of care new delivery models.

In light of the continued push for value, and even recent legislation included in December's 21st Century Cures Act, interoperability and health information exchange will also remain industry priorities for the foreseeable future. Infrastructures must support the consistent and accurate flow of data to drive performance improvement and enable healthcare organizations to measure, analyze, and report cost and quality metrics that will drive reimbursement under value-based payment models.

Where do we go from here?

Nearly every day there's a new headline about healthcare reform. NextGen is committed to helping providers cut through the noise and focus on what's important. Stop by our booth (#3361) at HIMSS17, where we will be separating the knowns from the unknowns, the "real" news from the "fake" news, and answering your healthcare reform questions to help dispel confusion about where the industry is headed.

To learn more about how to handle MACRA during this transition year, Check out our Definitive Guide to Value-Based Care. Join Government Affairs Advisor, Chris Emper, for late afternoon coffee at our booth #3361 on February 20th-21st to learn what you can do today to prepare for change.

The healthcare industry stepped into 2017 with a sense of unease—and understandably so. In addition to the usual list of issues that challenge healthcare organizations, this year President Trump’s pledge to repeal and replace the Affordable Care Act (ACA) and the start of the first MACRA performance period following last October’s 2,000 plus page final rule have sparked questions from every corner of the industry. How quickly will any changes stemming from the ACA repeal start taking place? What impact will those changes have on patient access and provider patient populations? Where is the industry headed in terms of payment reform?

Do these sound familiar? You’re not alone in your uncertainty.

While the answers to some of these questions may not surface for a while, there is one certainty providers can bank on: the broader shift to value-based reimbursement is here to stay.

What do we know is certain?

Amidst the uncertainty surrounding the ACA, there have yet to be any serious discussions about making fundamental changes to MACRA. The reason? Despite, its flaws and limitations, the MACRA law was a bipartisan effort more than a decade in the making that itself represents the unsustainability of the fee-for-service payment system. Furthermore, MACRA is just one component of the industry's shift towards value, which is being driven by both government and market forces. As such, providers must continue to align their 2017 priorities to enable success under MACRA's new Quality Payment Program, including making critical assessments of existing technology infrastructure and detailed evaluations of care new delivery models.

In light of the continued push for value, and even recent legislation included in December's 21st Century Cures Act, interoperability and health information exchange will also remain industry priorities for the foreseeable future. Infrastructures must support the consistent and accurate flow of data to drive performance improvement and enable healthcare organizations to measure, analyze, and report cost and quality metrics that will drive reimbursement under value-based payment models.

Where do we go from here?

Nearly every day there's a new headline about healthcare reform. NextGen is committed to helping providers cut through the noise and focus on what's important. Stop by our booth (#3361) at HIMSS17, where we will be separating the knowns from the unknowns, the "real" news from the "fake" news, and answering your healthcare reform questions to help dispel confusion about where the industry is headed.

To learn more about how to handle MACRA during this transition year, Check out our Definitive Guide to Value-Based Care. Join Government Affairs Advisor, Chris Emper, for late afternoon coffee at our booth #3361 on February 20th-21st to learn what you can do today to prepare for change.


Chris Emper

Government Affairs Advisor, NextGen Healthcare

Chris Emper, JD, MBA, is government affairs advisor at NextGen Healthcare and president of Emper Healthcare Advisors—a health IT industry advisory and consulting services firm in Washington, D.C. that specializes in helping healthcare providers and technology companies successfully navigate and comply with complex regulations and value-based reimbursement models. Prior to forming Emper Healthcare Advisors in 2016, Chris was vice president of Government Affairs at NextGen Healthcare (NASDAQ: NXGN) and Chair of the Electronic Health Record Association (EHRA) Public Policy committee…

Chris Emper, JD, MBA, is government affairs advisor at NextGen Healthcare and president of Emper Healthcare Advisors—a health IT industry advisory and consulting services firm in Washington, D.C. that specializes in helping healthcare providers and technology companies successfully navigate and comply with complex regulations and value-based reimbursement models. Prior to forming Emper Healthcare Advisors in 2016, Chris was vice president of Government Affairs at NextGen Healthcare (NASDAQ: NXGN) and Chair of the Electronic Health Record Association (EHRA) Public Policy committee.

An expert in The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), The Patient Protection and Affordable Care Act (ACA), and The 21st Century Cures Act, Chris is a frequent speaker at industry conferences and has written or appeared in articles in publications such as Politico, Health Data Management, Accountable Care News, and Medical Economics. From 2016-2019, Chris served as Chair of the HIMSS Government Relations Roundtable, a leading coalition of health IT government affairs professionals.

Prior to joining NextGen Healthcare in 2013, Chris served as a Domestic Policy Advisor for former Massachusetts Governor Mitt Romney’s 2012 Presidential Campaign, where he advised the campaign on policy issues including healthcare, technology, and innovation. He holds a law degree and an MBA from Villanova University and a BA from Boston College.

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