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CMS elevates electronic health records interoperability

CMS is replacing meaningful use with 'Promoting Interoperability' and proposing new Medicare payment programs with looser physician reporting rules and more price transparency.

CMS has officially killed off meaningful use and replaced it with new and revamped programs intended to advance electronic health records interoperability, ease physician reporting requirements and promote hospital price transparency.

In essence codifying the plan CMS administrator Seema Verma outlined at the HIMSS 2018 conference in March, the agency laid out a new program -- "Promoting Interoperability" -- to replace the meaningful use program created by the HITECH Act of 2009.

"Today's proposed rule demonstrates our commitment to patient access to high-quality care while removing outdated and redundant regulations on providers," Verma said in an April 24 release.

Electronic health records interoperability push

The new electronic health records interoperability initiative keeps the health IT certification program from meaningful use that requires healthcare providers to use health IT systems that meet 2015 Edition criteria.

Seema Verma, CMS administratorSeema Verma

But CMS is accentuating the use of APIs in achieving electronic health records interoperability and soliciting feedback to generate new rules to "revive" interoperability, according to a CMS release.

"CMS is proposing to make changes to the EHR Incentive Program to greater promote interoperability and to make the EHR Incentive Program more flexible and less burdensome by placing a strong emphasis on measures that require the exchange of health information between providers and patients," CMS said in a fact sheet.

CHIME has mixed reaction

The College of Healthcare Information Management Executives (CHIME), in a statement, commended CMS for "making interoperability a focus" and for removing a "pass-fail" policy from CMS payment programs with rulemaking flexibility Congress granted the agency last year. But the group also said it is still evaluating proposed changes to the quality scoring methodology.

Cletis Earle, CHIME board of trustees chairmanCletis Earle

"We appreciate that CMS has considered the potential burdens, as well as benefits, that policy changes involving healthcare IT can impose on hospitals and healthcare systems," said Cletis Earle, CHIME board of trustees chairman, in the statement. "We continue to urge caution as CMS moves ahead with changes to ensure that they facilitate quality care and lead to measurable improvements."

The proposed change would go into effect in 2019 and would keep the existing 90-day quality measure reporting period for 2019 and 2020.

Changes to payment programs

In addition to promoting electronic health records interoperability, CMS proposed changes to the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) that would remove what the agency said are "unnecessary, redundant, and process-driven" quality measures.

Today's proposed rule demonstrates our commitment to patient access to high-quality care while removing outdated and redundant regulations on providers.
Seema Vermaadministrator, CMS

The result would be the elimination of 19 quality reporting measures and the "de-duplication" of 21 other measures "while still maintaining meaningful measures of hospital quality and patient safety," according to the release.

In total, CMS said it is proposing to remove 25 measures across five programs, which the agency said would save physicians more than two million "burden hours" and save hospitals and healthcare systems $75 million.

"CMS is proposing this new flexibility so that hospitals can spend more time providing care to their patients thereby improving the quality of care their patients receive," the release said.

Price visibility

Also under the program to promote electronic health records interoperability, CMS put forth proposed rules to strengthen an existing mandate for hospitals to post lists of standard charges and make the charges available to the public on request.

The agency is also seeking comment on ways to make medical prices more available and understandable and to help providers develop "patient-friendly interfaces" so consumers can more easily compare prices.

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