Health IT and ACA challenges

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October 07, 2016

Welcome to The ACP Advocate,

Today’s first article presents the numerous challenges facing the Affordable Care Act as it enters its fourth marketplace enrollment year. It looks at how premium increases in some markets, the withdrawal of three insurance behemoths from the marketplace exchanges, and uncertainty in the outcome of this November's presidential and congressional elections has led some to be unsure of the ACA's future.

The other article in this issue looks at the numerous online resources promoted as part of the annual National Health IT Week. The article highlights features of the federally produced Health IT Playbook, EHR Contracts Untangled, and a HHS video for patients on understanding their digital health care footprints.

The next ACP Advocate newsletter will be distributed on Oct. 21. It will further examine the impact ACA has had on the market and the positions presidential candidates have taken on key ACP issues and priorities.

For more coverage of what's happening in Washington, take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty. You can also follow me on Twitter @BobDohertyACP.

As always, please send your feedback and suggestions on this newsletter to:

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians

In the news
» Challenges Mount for Affordable Care Act as Fourth Year Approaches

Election outcome seen as key to resolving latest marketplace issues

Premium increases and the departure of several large companies from the health insurance marketplaces are among an assortment of issues paving a bumpy path to 2017 for the Affordable Care Act.

"I d... (read more)

» Putting a New Face on Health IT

Three offerings aim to help make technology less daunting to physicians and patients

Just the words "health IT" can be enough to send many Americans into reveries about their worst experiences with technology at the doctor's office. "I have one doctor who doesn't look at me anymore -- he jus... (read more)

About this newsletter
The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to
In this issue
» Challenges Mount for Affordable Care Act as Fourth Year Approaches
» Putting a New Face on Health IT

In focus
» CMS Updates -- PQRS and QRURs
CMS recently released the Physician Quality Reporting System (PQRS) Feedback Reports and Quality and Resource Use Reports (QRURs) for calendar year 2015. These reports show 2015 program results for PQRS and Value Modifier programs and are now available for review to determine whether physicians are subject to the 2017 PQRS negative payment adjustment and the 2017 Value Modifier payment adjustment. Solo physicians and physician groups have through Nov. 30, 2016, to submit an informal review if they believe they were assessed incorrectly.
» Confused about MACRA? You're not alone.
Confused about MACRA? A new video proves you aren't the only one. Those regulatory terms and acronyms make an alphabet soup. ACP has resources that can help you prepare for MACRA both now and after the final rule is issued.
» ICD-10 coding update: Contingency period has ended
Claims had to include ICD-10-CM codes to the highest level of specificity possible based on documentation beginning Oct. 1, 2016. The one-year contingency period, during which clinicians were not penalized for billing non-specific codes (when a more specific code was available), ended on the last day of September. See page 8 (#25) of the linked Q&A on ICD-10 from CMS.

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