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CMS Seeks to Improve Interoperability With Public Policy Changes

CMS Administrator Seema Verma outlined the federal agency’s plans to push interoperability forward at an FAH public policy conference.

CMS Administrator Seema Verma outlined recent efforts to improve interoperability through public policy.

Source: Thinkstock

By Kate Monica

- At a recent Federation of American Hospitals (FAH) 2019 Public Policy Conference, CMS Administrator Seema Verma reaffirmed the federal agency’s commitment to improving interoperability through several policy changes.

“With interoperability and the seamless flow of data, we can change the way health care in this country operates,” said Verma. “Patients can have access to their health information to understand and engage in their health care to make the best and most informed decisions possible.”

“Providers can provide high-quality, coordinated care for their patients without repeating tests and ensuring safety and quality, resulting in better care and improved outcomes,” Verma added.

Improving interoperability could also lead to significant breakthroughs in research, with researchers gaining access to de-identified EHR patient data.

“We have taken steps to ensure patients have access to their health information and we will continue driving this effort with every lever we have,” said Verma.

READ MORE: EHRA Urges CMS, ONC to Extend Interoperability Rule Comment Period

Changing the meaningful use program to the Promoting Interoperability (PI) program is one significant step CMS has taken to boost health data exchange through public policy changes.

“In our new Promoting Interoperability Programs, clinicians and hospitals are no longer incentivized or penalized based on just using an EHR,” said Verma.

“We eliminated thresholds and removed check-the-box measures in favor of scoring based on performance and results around interoperability and giving patients their data,” she continued. “We meant what we said about putting patients at the center of the system; nearly half of a hospital or clinician’s score in these programs is now based solely on sharing data with patients.”

CMS is also taking steps to ensure payers also engage in health data exchange and make financial and clinical information available to patients through application programming interfaces (APIs).

“Because of Blue Button 2.0, over 1,500 app developers are now building user-friendly apps that help seniors understand and access their data, like sharing their claims history with their doctor, and generating medication lists and reminders for care,” said Verma.

Combined with a proposed Interoperability and Patient Access proposed rule, Verma hopes to see public policy spur significant advancements in patient data access.

READ MORE: AHA Opposes Key Information Blocking Regulation in CMS Proposed Rule

“With all of those plans on board, by 2020, 85 million more patients will have access to their health claims information, in addition to the 40 million who already have access through Blue Button 2.0,” Verma maintained.

“Patients should own their data and it should be able to move seamlessly with them as they move throughout the healthcare system—from doctor to doctor and plan to plan, over the course of their lifetime,” Verma added.

Another proposal in the Interoperability and Patient Access Rule would require hospitals to send electronic notifications to doctors and caregivers when a patient is admitted, discharged, or transferred from the hospital.

AHA recently stated its opposition for this proposed policy, stating the regulation would increase requirements for hospitals and contribute to already high rates of administrative burden.

However, Verma maintained while some regulations will ramp up for hospitals, other requirements deemed less meaningful will be eliminated.

READ MORE: CMS Proposes Publicly Identifying Information Blocking Providers

“That’s why we launched our “Meaningful Measures” initiative in 2017,” Verma said. “We rolled back nearly 20 percent of measures because they were either topped out, duplicative, or simply overly burdensome to report for very little gain.”

The Meaningful Measures initiative prompts regulators to implement quality metrics that evaluate core issues most vital to high-quality care delivery and improved patient health outcomes.

“While I am so proud of this accomplishment, we are continuing our work toward reaching a smaller set of high-quality, dynamic measures that impose less burden on providers and that help us obtain information patients can use to identify high value providers,” said Verma.

As part of the effort to simplify federal regulation, CMS is also working to update Stark Law regulations.

“Some of the changes include clarifying the regulatory definitions of volume or value, commercial reasonableness and fair market value; addressing issues such as lack of signature, incorrect dates or other areas of technical noncompliance; and updating the regulation to address a world in which there are cybersecurity and electronic health records requirements,” said Verma.

“This will represent the most significant changes to the Stark law since its inception. It is our hope that these changes will help spur better care coordination and help support our work to remove barriers to innovation while continuing to provide appropriate safeguards for our programs,” Verma continued.

Overall, CMS is focused on crafting public policy that enables a more efficient, patient-centered, innovative healthcare system.

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