Stream: social
Topic: Medicare Pmt Sys Modernization
Dave deBronkart (Aug 06 2019 at 18:27):
Branching off of [the DME thread[(https://chat.fhir.org/#narrow/stream/179160-social/topic/DME) -
The idea is to cut down on the need to reach out to providers for information and have it readily available for our Reimbursement teams. With our current process, our teams find themselves frequently sending emails or calling over for the providers to fax in the patient information. We would essentially eliminate the fax request ...
@Don thomas and all, there may be some relevance to this:
Last week I spoke at a first gathering of a major new initiative, MPSM - Medicare Payment System Modernization. Evidently the whole Medicare payment system is built on a 50 year old foundation, to the point where one factor driving modernisation is that they can no longer find anyone who can maintain the ancient languages used in some part.)
Relevant to this thread is that one massive pain point discussed by the physician speaker was the near-impossibility for handling prior authorisations, consuming enormous unpaid time by physicians and others. (I'm so heartened that this early organizing meeting featured both a patient voice (me) and a voice of suffering physicians - actual end user perspective! The project is built on human-centered design principles, they say, in which end users must be involved from the beginning.)
Important in general and specifically for FHIR is that the MPSM project is led by USDS, the US Digital Service, which was created in the previous administration after the spectacular failure of the Healthcare.gov website where people were to register for ObamaCare. USDS is not part of HHS or any other department - they're just fast-moving modern thinkers. (The people I spoke to leading MPSM have all been government employees for less than six months - no career bureaucrats with crony vendor networks here... yet, anyway!)
Last updated: Apr 12 2022 at 19:14 UTC
