Following the Centers for Medicare & Medicaid Services’ (CMS) April 2018 rule proposal announcement, comes the finalization of the “Promoting Interoperability” rule (PI, formerly known as the Meaningful Use program, or Medicare and Medicaid EHR Incentive Program). CMS hopes that by reshaping the rule to be more concise and less burdensome, more eligible physicians, hospitals, and critical access hospitals (CAHs) can start worrying less about paperwork and shift their focus on ensuring transparent provider-patient health information exchange and transitioning into the PI program’s third and final stage in 2019.5,6
Starting October 1, 2018, the overhauled PI rule will apply to about 3,300 acute care hospitals and 420 long-term care hospitals, and includes the following key provisions:
- For new and returning EPs: Final EHR reporting period of at least 90 consecutive days, any time within each calendar year for 2019 and 2020.
- Beginning 2019, all EPs are required to employ 2015 editions of CEHRT.
- Those under Medicare Promoting Interoperability Program will follow updated performance-based scoring methods, based on a more condensed set of objectives.
- Two new e-Prescribing measures for opioids: Query of Prescription Drug Monitoring Programs (PDMP) will be optional in 2019, and shift to mandatory in 2020. Verify Opioid Treatment Agreement will be optional in 2019 and 2020.
- Meaningful Measures: Final rule de-duplicates and eliminates measures that add limited value, were too costly compared to perceived benefit, and do not directly address interoperability. Acute care hospitals are now required to report fewer measures across the four quality and value-based purchasing programs (Inpatient Quality Reporting, Value-Based Purchasing, Hospital-Acquired Conditions (HAC) Reduction, and Readmissions Reduction Programs).
“We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” said CMS Administrator Seema Verma. “We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes. Today’s final rule reflects public feedback on CMS proposals issued in April, and the agency’s patient-driven priorities of improving the quality and safety of care, advancing health information exchange and usability, and removing outdated or redundant regulations on healthcare providers to make way for innovation and greater value.” Click here for more detailed information about CMS’ final rule and how it affects your practice or institution. 1
More About the 3 Stages of the Promoting Interoperability Plan
These three stages, laid out when former President Barack Obama signed the American Recovery and Reinvestment Act of 2009 which included the Health Information Technology for Economic and Clinical Health ACT, aim to advance health IT and the “meaningful use” of electronic health record systems (EHRs) obtained via federally certified EHR technology (CEHRT). The CMS defined the PI program as having three stages eligible providers (EPs) must progress through to be incentivized:2
Stage 1 – Data Capturing and Sharing Launched in 2011 and laid the groundwork and standards for the proper capture and transmission of clinical data, while providing patients with electronic access to their health information upon request. EP compliance in the first stage ensures clinical quality data, ease of public health reporting, and encourages patients to be more involved in their healthcare.3
Stage 2 – Advancing Clinical Processes Began in 2014 and broadened the role CEHRT plays in better clinical decision support, care coordination, and patient engagement. Redundant criteria were either combined or removed, and new objectives and higher thresholds meant promoting interoperability across bigger patient populations to stay incentivized.4
Stage 3 – Improving Health Outcomes Optional compliance to the new requirements began in 2017 but will become mandatory in 2019. Objectives now revolve around perfecting practices established in Stage 2, improving the quality of captured health information, and smoother system-to-system transmission and data interpretation.1
PEPID is proud to offer personalized products that comply with the latest interoperability trends and regulations, helping eligible providers fulfill 3 out of the 8 requirements of Stage 3: 1) Protect electronic health information, 2) Implement clinical decision support, and through our Bedside Education tool 3) Provide patients with patient-specific health education. Chat with us today at 1.888.321.7828 to learn how a PEPID suite of your choice can get you 2019 compliant sooner.
- “CMS Finalizes Changes to Empower Patients and Reduce Administrative Burden | CMS.” Centers for Medicare & Medicaid Services, 2 Aug. 2018, https://www.cms.gov/newsroom/press-releases/cms-finalizes-changes-empower-patients-and-reduce-administrative-burden.
- “Meaningful Use Overview.” American Academy of Pediatrics, http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Informatics/Pages/Meaningful-Use-Overview.aspx.
- “Stage 1 Changes Tipsheet.” Centers for Medicare & Medicaid Services, Aug. 2012, cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1ChangesTipsheet.pdf.
- “Stage 2 Overview Tipsheet.” Centers for Medicare & Medicaid Services, Aug. 2012, http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2Overview_Tipsheet.pdf.
- Leventhal, Rajiv. “BREAKING: CMS Finalizes ‘Promoting Interoperability’ Rule.” Healthcare Informatics Magazine, 2 Aug. 2018, http://www.healthcare-informatics.com/article/value-based-care/breaking-cms-finalizes-promoting-interoperability-rule.
- Leventhal, Rajiv. “BREAKING: CMS to Rebrand Meaningful Use Program with New Emphasis on Interoperability, Burden Reduction.” Healthcare Informatics Magazine, 24 Apr. 2018, http://www.healthcare-informatics.com/article/payment/breaking-cms-overhaul-meaningful-use-program-new-emphasis-interoperability