CMS Program Overhaul to Promote Interoperability

The Centers for Medicare and Medicaid Services (CMS) announced a name change the EHR Incentive Programs as part of an effort to overhaul the programs.
As part of the proposed rule, the change aims to transform the EHR Incentive Programs also introducing changes to Medicare payment policy rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS)

“We seek to ensure the healthcare system puts patients first, Today’s proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers. We envision a system that rewards value over volume and where patients reap the benefits through more choices and better health outcomes. Secretary Azar has made such a value-based transformation in our healthcare system a top priority for HHS, and CMS is taking important, concrete steps toward achieving it.” Administrator Seema Verma states.

  • The EHR Incentive Programs will now be called Promoting Interoperability (PI) Program with eligible participants being hospitals, critical access hospitals and Medicaid Providers.
  • The MIPS Advancing Care Information performance category will now be changed to the Promoting Interoperability (PI) performance category, this program is available to all MIPS eligible clinicians.

The change moves the emphasis for both programs to objectives and measures that focus on interoperability as well as improvements to patient access of their health information.
CMS has also proposed changes to incorporate pieces of the MyHealthEData initiative which would strengthen interoperability and the sharing of healthcare data between providers.
Specifically, CMS plans to make changes to the EHR Incentive Programs in the following ways:

  • Make the program more flexible and less burdensome
  • Focus on measures that require the exchange of health information between Providers
  • Incentivize Providers to make it easier for patients to obtain their medical records electronically

The program also reinforces the requirement for Providers to use the 2015 Edition of CEHRT in 2019 to demonstrate meaningful use.

“This updated technology includes the use of application programming interfaces (APIs), which have the potential to improve the flow of information between providers and patients. Patients could collect their health information from multiple providers and potentially incorporate all of their health information into a single portal, application, program, or other software. This can support a patient’s ability to share their information with another member of their care team or with a new doctor, which can reduce duplication and provide continuity of care“ CMS notes.

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About the Author:

Christina is a Project Management and Application Specialist at eMedApps with over 20 years of experience in the Health Care industry. The Certified NextGen professional applies her clinical, IT and Quality background along with her NextGen system knowledge to aid practices in workflow enhancements, efficiency optimization, upgrades, reporting, CCM, PCMH, Meaningful Use, MIPS, quality initiatives and best practice implementation. Christina resides in Michigan and is detail orientated, organized, and has a positive can-do attitude. She thoroughly enjoys working with clients to achieve their goals.