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New CMS Proposed Rule to Reduce Hospital EHR Data Reporting

A new CMS proposed rule contains two provisions intended to reduce hospital eCQM reporting requirements in response to feedback calling for less aggressive EHR data reporting policies.

CMS Proposed rule change.

Source: Thinkstock

By Kate Monica

- A couple provisions in a new Hospital Inpatient Quality Reporting (IQR) Program rule proposal outline modifications to electronic clinical quality measure (eCQM) reporting requirements and validation processes.

In a public document in the Federal Register, CMS proposed reductions to hospital eCQM reporting policies. In the 2017 calendar year reporting period (and 2019 fiscal year payment determination), hospitals would be required to choose six available eCQMs listed in the Hospital IQR Program measure set and offer two chosen calendar year quarters of data.

CMS additionally proposed hospitals would need to submit six available eCQMs and provide data for the first three calendar quarters for the 2018 calendar year reporting period and 2020 fiscal year payment determination.

These proposed rule modifications are intended to bring down the number of required eCQMs and fiscal year quarters hospitals need to report previously set by the fiscal year 2017 IPPS/LTCH PPS final rule.

CMS is also proposing modifications to the eCQM validation process pending approval of the reporting requirement modifications. Pending finalization, CMS proposes hospitals be required to submit a decreased number of cases for eCQM data validation for the fiscal year 2020 and fiscal year 2021 payment determinations.

After closing the public comment period for the 2017 IPPS/LTCH PPS final rule, CMS combed through the submitted feedback regarding the difficulties hospitals and EHR vendors have faced when implementing eCQM reporting.

A few persistent concerns among hospitals and EHR vendors were as follows: 

The timing of the transition to a new EHR system during 2017 (or system upgrades or new EHR vendor) affects hospitals’ ability to report on an increased number of measures in a timely manner;

● There is a need for at least one year between new EHR requirements due to the varying 6- to 24-month cycles needed for vendors to code new measures, test and institute measure updates, train hospital staff, and rollout other upgraded features;

● Hospitals have had difficulty identifying applicable measures that reflect their patient population, given the reduction in the number of available eCQMs (from 28 to 15) for CY 2017 reporting; and

● Hospitals have had challenges with data mapping (aligning the information available in an electronic health record (EHR), particularly if the information is not located in a structured field (for example, PDF attachment, free text section) to the required fields in a QRDA Category I (QRDA I) file), and workflow (the process of extrapolating the pertinent patient data from an EHR, transferring that data to a QRDA I file, and submission of the QRDA I file to CMS) because hospitals still need to collect CY 2017 data while still reporting CY 2016 data.

In response, CMS reduced the number of available eCQMs hospitals are required to report from eight to six, and the number of required reported fiscal year data from a full year to two quarters.

Through these modifications, CMS intends to ease administrative burdens on providers, which will allow providers to focus more on adjusting to eCQMs through system upgrades and staff training.

Additionally, hospitals that successfully report data in 2016 will have an easier time reporting in 2017.

“Successful reporting in CY 2016 should streamline CY 2017 reporting because hospitals can re-use the same measures submitted to satisfy the CY 2016 reporting requirements,” stated the federal organization. 

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