Nursing Informatics Policy and Regulations: MACRA & Healthcare

This report delves into the realm of Nursing Informatics, specifically focusing on the Medicare Access and Children's Health Insurance Program (MACRA) of 2015. The report analyzes the impact of MACRA on healthcare regulations, emphasizing the shift from the Sustainable Growth Rate (SGR) to a Merit-based Incentive Payment System (MIPS). It highlights how this policy change affects healthcare professionals' payments, tying them to the quality of their services. Furthermore, the report discusses the implications of MACRA on clinical care and workflow, and how healthcare organizations can implement policies to comply with the regulations. The report also emphasizes how MACRA enhances the quality of healthcare services and resources by improving clinical care for children.

Running head: NURSING INFORMATICS POLICY AND REGULATIONS
NURSING INFORMATICS POLICY AND REGULATIONS
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Chosen Policy: MACRA
The relevant healthcare informatics policy which will be focused upon as a part of this
fact sheet is the Medicare Access and Children’s Health Insurance Program (CHIP)
Reauthorization Act of 2015 (MACRA), which was implemented by former President Barrack
Obama. In addition to ensuring overall improvement in the quality of the existing healthcare
services and resources, the aim of this policy is to ensure that healthcare professionals receive
fair payment for their services and healthcare costs associated with Medicare Part B are regulated
and controlled (Golding & Nicola, 2019).
Impact on System Regulation
One of key regulatory changes which MACRA paved the way for in the healthcare
system was to repeal the Sustainable Growth Rate (SGR) and instead, implement a Merit-based
Incentive Payment System (MIPS). As per the same, healthcare professionals like nurse
practitioners, physicians, clinical nurse assistants and physician assistants who will engage in
participation across MIPS will receive their yearly payment in terms of quality of performance
(Clough & McClellan, 2016).
Impact on Clinical Care and Workflow
Thus, as per MACRA, healthcare professionals will be paid in terms of the quality they
demonstrate across categories like meaningful use, clinical practice improvement, resource use
and clinical quality. This in turn, will motivate healthcare professionals to implement high
quality healthcare interventions which will pave the way for improved quality of clinical care
provided by a healthcare organizations. Additional, for the purpose of improving clinical care for

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children, MACRA also expanded the coverage provided by CHIP – an insurance for covering the
medical needs of children without insurance (Clough & McClellan, 2016).
Organizational Policies/Procedures
For the purpose of ensuring compliance to MACRA, the healthcare organization I am
currently engaged in will implement a composite scoring system ranging from 0 to 100.
Healthcare professionals, based on the same, will receive increased payment ranging from 0.5 to
0.75 % with higher scores received in areas of meaningful use, clinical practice improvement,
resource use and clinical quality (Golding & Nicola, 2019).

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References
Clough, J. D., & McClellan, M. (2016). Implementing MACRA: implications for physicians and
for physician leadership. Jama, 315(22), 2397-2398.
Golding, L. P., & Nicola, G. N. (2019). Medicare Access and Children’s Health Insurance
Program Reauthorization Act: The Basics for the Breast Imaging Radiologist. Journal of
Breast Imaging, 1(1), 47-50.