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CMS Finalizes Changes to Empower Patient EMR Access and Reduce Administrative Burden

On August 02, 2018, the Centers for Medicare & Medicaid Services (CMS) 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 in the 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.

The fiscal year 2019 Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (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.

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

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.

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