CMS elevates electronic health records interoperability

Hospitals may soon have to post their standard prices for patients online under a proposed rule unveiled Tuesday by the Trump administration

Hospitals may soon have to post their standard prices for patients online under a proposed rule unveiled Tuesday by the Trump administration

The Trump administration wants to require hospitals to post their prices online in an effort to improve transparency for patients, as health care comes into focus for the White House.

Hospitals were already required to make their list of standard charges public, but the new guidelines specify they make the prices readily available to any consumer surfing the web.

The policy changes to the Meaningful Use program-which has been renamed the "Promoting Interoperability" program-were released in a proposed rule for the 2019 Inpatient Prospective Payment Systems (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System, which includes an updated scoring methodology for eligible hospitals and critical access hospitals that would start in 2019, as well as the use of 90-day electronic health record reporting periods in 2019 and 2020. They apply mostly to Medicare patients and providers, but officials hope the changes cascade to other parts of the health care system. Seema Verma said the goal is to move away from a system that reimburses hospitals for the number of services they provide to one that rewards them for the value of their care.

"This payment proposal takes important steps toward a Medicare system that puts patients in charge of their care and allows them to receive the quality and price information needed to drive competition and increase value", Health and Human Services Secretary Alex Azar said.

This results in the elimination of 25 total measures across the five programs, saving hospitals over 2 million hours of work and $75 million.

DirectTrust CEO David Kibbe commended the federal agency's efforts to simplify the meaningful use program for hospitals and promote improvements in health data exchange. As part of that effort, the agency said it meant to prioritize the use of quality measures and improvement activities in value-based care and quality programs that lead to interoperability.

CMS is proposing for the inpatient prospective payment system and the long-term care hospital prospective payment system to remove unnecessary, redundant, and process-driven measures from a number of quality reporting and pay-for-performance programs.

"We are removing measures that are topped-out - meaning the overwhelming majority of providers are performing well on them - duplicative measures, and measures that are excessively burdensome to report", stated Verma.

"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, chair of the CHIME Board of Trustees, in a written statement.

Last year, the AHA reported that providers spent close to $39 billion in one year exclusively on administrative duties related to regulatory compliance. In the proposed rule, CMS is requesting stakeholder feedback through a Request for Information on the possibility of revising Conditions of Participation to revive interoperability as a way to increase electronic sharing of data by hospitals.

The American Hospital Association had no comment on this part of the rule either, but said it was disappointing that the agency would require the use of 2015 edition EHR technology beginning in 2019.

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