CMS unveils new rules aimed at clinician burden, patient experience

The Omnibus Burden Reduction and Discharge Planning rules both aim to reduce red tape and enable transparency, says Centers for Medicare & Medicaid Services Administrator Seema Verma.
By Mike Miliard
12:08 PM

As part of its Patients Over Paperwork initiative, the Centers for Medicare & Medicaid Services unveiled its Omnibus Burden Reduction Final Rule on Thursday, aimed at combating clinician burnout.

It also finalized a new rule on discharge planning, aimed at patients preparing to move from hospitals into post-acute care settings, requiring hospitals to provide information about PAC provider choices.

WHY IT MATTERS
Together, the rules seek to improve the experience of providers and patients, respectively, said CMS Administrator Seema Verma on a conference call, and are part of a larger effort to remove "regulatory requirements that stand like a brick wall between patients and their doctors and yet do nothing to advance patient safety or health."

The Omnibus Burden Reduction Final Rule takes aim at what CMS estimates is 4.4 million hours spent on paperwork each year, and could enable $8 billion in savings over the next decade while also giving physicians more time to spend with their patients.

Among its many provisions, the rule focuses on kidney care, Verma said, finalizing changes to transplant center requirements that give providers greater flexibility to support patients who need organ transplants.

Current Medicare transplant center regulations for re-approval are burdensome, she explained – to the point that some transplant programs avoid performing transplants for certain patients. The Omnibus rule will eliminate these requirements, specifically for data submission, increasing the number of organs available for transplantation and helping ensure patients on the transplant waiting list have access to transplants, Verma said.

The final rule also will streamline regulations to allow multiple hospitals within a given health system to employ a unified Quality Assessment and Performance Improvement program, according to CMS, making it easier for hospitals to implement best practices and innovations among facilities resulting in quicker improvements in quality of care.

"This will ease the strain on small facilities and allow them to trial from the clinical expertise in the larger system," Verma said.

Also under the new regulation, orders for X-rays may be transmitted in written form, by telephone or electronically, rather than written and signed, as was previously required. 

Additionally, CMS is reducing the frequency of policy reviews and program evaluations that rural health clinics and federally qualified health centers are required to conduct from annually to once every two years.

"It's incredibly important for providers to have up-to-date plans in place to deal with unthinkable catastrophic events," Verma said. "However, stakeholders were generally supportive of our proposal to eliminate annual emergency preparedness review requirements."

THE LARGER TREND
With its Discharge Planning Rule, meanwhile, CMS says it supports patient experience and interoperability goals.

The final rule, aimed at patients transitioning to post-acute care settings, requires hospitals to give access to information about PAC provider choices – including performance on important quality measures and resource-use measures such as the prevalence of pressure ulcers number of readmissions back to the hospital.

By requiring the seamless exchange of patient information between healthcare settings, and ensuring that a patient’s healthcare information follows them after discharge from a hospital or PAC provider, the rule is meant to boost interoperability, Verma explained. It requires the discharge planning process to focus on a patients' treatment preferences and mandates the right to access their medical records in an electronic format.

"Patients who are discharged from care setting need and deserve to know how their transition will be handled," Verma stated. "This rule makes that a reality. It promotes interoperability by requiring that patients have access to their medical records in the format that they request including electronically."

ON THE RECORD
"In my trips across the country, I’ve heard time and again that unnecessary regulations are increasing costs on providers and they are losing time with patients as a result," said Verma in a statement on the Omnibus Burden Reduction rule. "This final rule brings a common sense approach to reducing regulations and gives providers more time to care for their patients, while reducing administrative costs and improving health outcomes.”

As for the discharge planning rule, she called it a "huge step to providing patients with the ability to make healthcare decisions that are right for them, and gives them transparency into what used to be an opaque and confusing process. By demystifying the discharge planning process, we are improving care coordination and making the system work better for patients."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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