VIRGIL DICKSON | APRIL 24, 2018
(Updated at 9 p.m. ET)
The CMS has proposed an overhaul of the meaningful use program and wants hospitals to disclose their prices to patients.
The changes were outlined in the proposed annual inpatient hospital rule. Overall, the CMS estimates the rule’s various provisions will give hospitals $4.1 billion more in Medicare inpatient funding next year. If finalized, that amount is more than last fiscal year’s $2.4 billion bump in inpatient funding.
Comments on the proposed rule are due June 25.
“We seek to ensure the healthcare system puts patients first,” CMS Administrator Seema Verma said in a comment. “Today’s proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers.”
The CMS already requires hospitals to either publicly list their standard charges or give them to the public upon request. On Tuesday, the agency announced that hospitals must post this information.
It’s unclear whether the HHS has the legal authority to make this change, or how difficult implementation could be considering the technical nature of hospital billing practices.
“Given the inherent complexity of hospital billing, making prices easy to understand is clearly a lot easier said than done,” Shawn Gremminger, senior director of federal relations at Families USA and former staffer at America’s Essential Hospitals tweeted on Tuesday.
The agency also wants to overhaul the meaningful use program to better emphasize measures that require the exchange of health information between providers and patients and give providers incentives to make it easier for patients to obtain their medical records electronically.
To reflect these priorities, it is re-naming the meaningful use program to “promoting interoperability.”
The proposed rule encourages providers to use application programming interfaces that would allow patients to collect their health information from multiple providers and potentially incorporate all of their health information into a single portal, application or other software. That would allow patients to share their records with other clinicians in an easier manner, which could reduce duplication and provide continuity of care.
“With this proposal, we are finally seeing momentum that will better enable providers to unlock data and move it across platforms and settings to improve quality, efficiency and outcomes,” Blair Childs, senior vice president of public affairs for Premier, said in a statement.
But providers will still need to use an old edition of certified electronic health record technology next year in order to qualify for incentive payments and avoid reductions to Medicare payments under meaningful use.
Hospitals were thrilled with the CMS’ surprise proposal to eliminate the so-called 25% rule that would ding Medicare reimbursement rates for long-term care hospitals. Under the long-postponed policy, if more than a quarter of a long-term care hospital’s patients come from a single acute-care hospital, the long-term care hospital would receive a reduced Medicare reimbursement rate for patients exceeding that threshold.
The reduced rate would be between 50% to 60% less than what they would have received otherwise, according to the National Association of Long Term Hospitals.
The 25% rule was first introduced in a 2004 inpatient pay rule and has been delayed frequently by both the CMS and Congress in response to industry concerns. It was scheduled to finally kick in on Oct. 1.
“This will help ensure that patients get the care they need when they need it without facing arbitrary restrictions by non-patient-centered regulations,” Tom Nickels, executive vice president at the American Hospital Association said in a statement.
Finally, the rule will decrease the number of quality measures hospitals must report on. A total of 19 measures would be dropped, saving hospitals $75 million in reporting costs. The CMS said the measures were redundant and process-driven.
“With this proposed rule, we’ve finally taken a giant leap forward toward harmonizing measurement around indicators that truly matter, and avoiding duplication across programs,” Childs said.
Source: Modern Healthcare
http://www.modernhealthcare.com/article/20180424/TRANSFORMATION04/180429951