CMS proposes modifications to the Promoting Interoperability Program
As part of the Centers for Medicare and Medicaid Services' proposed rules this week around Medicare fee-for-service payment rates and policies for hospitals and long-term facilities – changes that could boost FY 2022 hospital payments by $2.8% – there are several provisions focused on technology, information exchange and patient access.
WHY IT MATTERS
Most notably, there are a series of proposed changes to CMS' Promoting Interoperability Program – the successor to meaningful use – designed to bolster the response to public health emergencies such as COVID-19.
The agency plans to amend program stipulations for eligible hospitals and critical access hospitals – broadening requirements focused on public health and clinical data exchange.
The proposed rule would make it mandatory for hospitals to report on four measures, rather than allowing a pick-and-choose approach, as had been the case before:
- Syndromic Surveillance Reporting.
- Immunization Registry Reporting.
- Electronic Case Reporting.
- Electronic Reportable Laboratory Result Reporting.
"Requiring hospitals to report these four measures would help to prepare public health agencies to respond to future health threats and a long-term COVID-19 recovery by strengthening public health functions, including early warning surveillance, case surveillance and vaccine uptake, which will increase the information available to help hospitals better serve their patients," said CMS officials.
The new requirements would enable nationwide syndromic surveillance that could help provide early notices of emerging disease outbreaks, according to CMS.
Additionally, automated case and lab reporting would speed response times for public health agencies, while broader and more granular visibility into immunization uptake patterns would help these agencies tailor their vaccine distribution plans.
As outlined on the CMS proposed rule fact sheet, these Promoting Interoperability Program changes are proposed for eligible hospitals and CAHs:
- Continue the EHR reporting period of a minimum of any continuous 90-day period for new and returning eligible hospitals and CAHs for CY 2023, and increase the EHR reporting period to a minimum of any continuous 180-day period for new and returning eligible hospitals and CAHs for CY 2024.
- Maintain the Electronic Prescribing Objective’s Query of PDMP measure as optional, while increasing its available bonus from 5 points to 10 points.
- Modify technical specifications of the Provide Patients Electronic Access to Their Health Information measure to include establishing a data availability requirement.
- Add a new HIE Bi-Directional Exchange measure as a yes/no attestation, beginning in CY 2022, to the HIE objective as an optional alternative to the two existing measures.
- Require reporting “yes” on four of the existing Public Health and Clinical Data Exchange Objective measures (Syndromic Surveillance Reporting, Immunization Registry Reporting, Electronic Case Reporting and Electronic Reportable Laboratory Result Reporting), or requesting applicable exclusion(s).
- Attest to having completed an annual assessment of all nine guides in the SAFER Guides measure, under the Protect Patient Health Information objective.
- Remove attestation statements 2 and 3 from the Promoting Interoperability Program’s prevention of information blocking attestation requirement.
- Increase the minimum required score for the objectives and measures from 50 points to 60 points (out of 100 points) to be considered a meaningful EHR user.
- Adopt two new eCQMs to the Medicare Promoting Interoperability Program’s eCQM measure set, beginning with the reporting period in CY 2023, in addition to removing four eCQMs from the measure set beginning with the reporting period in CY 2024 (in alignment with proposals for the Hospital IQR Program).
THE LARGER TREND
In other changes, CMS is proposing an extension for the New COVID-19 Treatments Add-on Payment it established this past November. The proposed rule would extend the NCTAP for "certain eligible technologies through the end of the fiscal year" in which the public health emergency ends.
The agency also wants to improve public health response by "leveraging meaningful measures for quality programs."
CMS wants to require hospitals to report COVID-19 vaccinations of workers in their facilities via the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure.
"This proposed measure is designed to assess whether hospitals are taking steps to limit the spread of COVID-19 among their workforce, reduce the risk of transmission within their facilities, help sustain the ability of hospitals to continue serving their communities through the public health emergency, and assess the nation’s long-term recovery and readiness efforts," said officials.
Additionally, CMS wants public comments on its plans to modernize the quality measurement program. As described in the fact sheet, its proposals include:
- Clarifying the definition of digital-quality measures.
- Using the FHIR standard for eCQMs that are currently in the various quality programs.
- Standardizing data required for quality measures for collection via FHIR-based APIs.
- Leveraging technological opportunities to facilitate digital quality measurement.
- Better supporting data aggregation.
- Developing a common portfolio of measures for potential alignment across CMS-regulated programs, federal programs and agencies, and the private sector.
ON THE RECORD
"Hospitals are often the backbone of rural communities – but the COVID-19 pandemic has hit rural hospitals hard, and too many are struggling to stay afloat,” said HHS Secretary Xavier Becerra, in a statement.
"This rule will give hospitals more relief and additional tools to care for COVID-19 patients, and it will also bolster the health care workforce in rural and underserved communities."