Policy & Regulation News

MyHealthEData, Patients Over Paperwork Key in CMS Final Rules

IPPS and LTCH PPS final rules will promote Patients Over Paperwork and the MyHealthEData initiative as part of CMS assertions to patient-centricity.

patients over paperwork myhealthedata

By Sara Heath

- CMS has issued final rules related to the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System. Finalized changes will support patient-centered care by reinforcing the MyHealthEData and Patients Over Paperwork initiatives.

These final rules, alongside other updates made earlier this week, will help empower patients to access their own health data while granting providers more time to spend with their patients through administrative simplification, according to CMS Administrator Seema Verma.

“We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” Verma said in a press release. “We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes. Today’s final rule reflects public feedback on CMS proposals issued in April, and the agency’s patient-driven priorities of improving the quality and safety of care, advancing health information exchange and usability, and removing outdated or redundant regulations on healthcare providers to make way for innovation and greater value.”

The fiscal year 2019 IPPS and LTCH PPS rules mandate price transparency for patients, health data exchange between patients and providers, and the reduction of administrative burden that CMS says prevents providers from building strong patient-provider relationships. Ultimately, these moves aim to empower patients with the information necessary to make decisions about their own care.

Price transparency mandates will require hospitals to list their prices online in a “machine-readable format.” Previously, hospitals were required to make their prices publicly available, but not necessarily in a digital format. Digital price transparency will enable patients to more easily access this information, CMS explained.

CMS is still fielding public comment about the best strategies for publicly displaying cost information to be most accessible and understandable for patients, the agency added.

The final rules also begin implementation of the MyHealthEData initiative, announced earlier this year. Specifically, the rules call for overhauls of the meaningful use programs, including:

  • Making the program more flexible and less burdensome
  • Emphasizing measures that require the exchange of health information between providers and patients
  • Incentivizing providers to make it easier for patients to obtain their medical records electronically

CMS has also made changes to meaningful measures, a set of quality measures that focus on patient safety and care quality. The agency has gotten rid of what it says are duplicative or redundant measures. These changes get rid of a total of 18 measures and de-duplicates 25 measures, while still “ensuring meaningful measures of hospital quality and patient safety,” the agency said.

In addition to promoting the notion of “patients over paperwork,” CMS has introduced the Patient-Driven Payment Model (PDMP) to the Skilled Nursing Facility Prospective Payment System (SNF PPS). This model will offer reimbursements based on treatment of the whole patient instead of the volume of services rendered.

Also as a part of the new SNF payment model, CMS says patients will have more flexibility in choosing a skilled nursing facility that fits their specific care needs.

In addition to these patient-centered rule changes, CMS says the IPPS/LTCH PPS final rules will yield average pay increases of 3 percent for acute care hospitals. That pay increase reflects mandatory rate updates as well as payments for new technologies and uncompensated care.

CMS also issued final rules for Skilled Nursing Facility (SNF) PPS, Inpatient Psychiatric Facility (IPF) PPS, Inpatient Rehabilitation Facility (IRF) PPS, and the Hospice Wage Index and Payment Rate Update earlier this week. Those final rules also encapsulate the agency’s efforts to drive patient-centered care, CMS said.


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