The key to that success is a physician governance structure that allows for frequent physician engagement and feedback, Wilding says. "Also, we have end-user work groups that have allowed our staff that work in the practices and in the hospitals to provide feedback on the day-to-day impact of the program."
Wilding is responsible for the day-to-day operations of the IT department as well as the meaningful use program for the medical system. "Ongoing analysis continues as we seek to better understand how the new proposed legislation directly impacts our employed providers and the medical system at large," she says.
UMMS' implementation of the Epic EHR makes Wilding confident that "while we still have some build and testing we're going to have to roll out as a result of MACRA changes, we believe it's manageable."
"How fast do you burn your existing fee-for-service structures down to replace them with value-based care? It's where you've got point-of-care systems built into your EMR to where the doc can know what needs to happen on this patient right now."
Wilding also says she thinks that MACRA may resolve some physicians' concerns. "You had these silly metrics that were kind of arbitrary and didn't necessarily mean that you were providing better care or were more efficient."
One potential distraction at UMMS: upgrading by this fall from the 2012 version of Epic to the 2015 version, Wilding says.
Two other health systems represent the wide spectrum of preparedness to leave fee-for-service behind, the desired outcome for MACRA.
At Mosaic Life Care, anchored by a 350-licensed-bed hospital in St. Joseph, Missouri, Joe Boyce, MD, chief technology officer and chief medical information officer, says the key to thriving in the age of MACRA comes down to "how fast do you burn your existing fee-for-service structures down to replace them with value-based care. It's where you've got point-of-care systems built into your EMR to where the doc can know what needs to happen on this patient right now."
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.