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CMS Proposes Quality Payment Program Changes, Administrative Relief

Proposed changes to Year 3 of the Quality Payment Program aim to reduce administrative burden and promote interoperability.

CMS announced changes to the Quality Payment Program.

Source: Thinkstock

By Kate Monica

- CMS has proposed key changes to the Quality Payment Program (QPP) intended to reduce administrative burden, shift the focus from process-based measures to outcomes-based measures, and promote EHR interoperability.

The 2019 QPP proposed changes would affect Year 3 of the program.

The changes may help to reduce administrative burden on providers by removing process-based quality measures within the Merit-Based Incentive Payment System (MIPS) that clinicians have called low-value or low-priority.

By removing low-priority, process-based measures from reporting requirements, the federal agency plans to focus only on meaningful measures that effectively improve patient health outcomes.

The proposed rule will also overhaul the MIPS Promoting Interoperability performance category to support improvements in EHR interoperability and patient access to health information.

Furthermore, the proposed changes will align the Promoting Interoperability performance category with the proposed Promoting Interoperability (PI) Program that may replace meaningful use for hospitals.

CMS stated the proposed changes to QPP are reflective of provider and stakeholder feedback. The federal agency will continue to offer providers free and customized technical assistance and support throughout the reporting process.

“Today’s proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients,” said CMS Administrator Seema Verma. “Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This Administration has listened and is taking action.”

In addition, CMS included several provisions in the proposed 2019 Physician Fee Schedule that will allow physicians to focus on patient care delivery rather than data entry and paperwork.

The proposed fee schedule includes provisions that will simplify, streamline, and allow flexibility in evaluation and management (E/M) clinical documentation requirements.

E/M requirements task providers with creating medical records based on predefined templates and boilerplate text that largely center on billing rather than patient medical histories. These requirements can be clinically inefficient and consume a significant portion of providers’ time.

The proposed rule would also reduce unnecessary physician supervision of radiologist assistants for diagnostic tests and removes burdensome and overly-complex functional status reporting requirements for outpatient therapy.

“The proposed changes to the Physician Fee Schedule and Quality Payment Program address those problems head-on, by streamlining documentation requirements to focus on patient care and by modernizing payment policies so seniors and others covered by Medicare can take advantage of the latest technologies to get the quality care they need,” said Verma.

Ultimately, the proposed changes are designed to let clinicians use EHR systems to document clinically-relevant information rather than information used only for billing purposes.



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