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What to Know About the New CMS Interoperability Rule


The agency says it’s all about empowering patients, providers and data sharing.

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The Centers for Medicare & Medicaid Services (CMS) has cemented an interoperability rule (PDF) that it hopes will improve the flow of data to patients and ease administrative requirements for providers. But how does it plan to do so?

The final rule, published yesterday, increases Medicare payment policies by an average of 3 percent for providers using the Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System. What’s more, the document requires hospitals to post information regarding their standard charges online and institutes technological requirements so that patients may better access and share their medical data digitally.

>> READ: CMS Says New Rule Could Save Clinicians 51 Hours of Paperwork Per Year

“We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” CMS Administrator Seema Verma, M.P.H., said in a statement. “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.”

The rule will affect roughly 3,300 acute care hospitals and 420 long-term care hospitals, beginning Oct. 1. It follows a series of final rules that came to light this week, which focused on nursing, psychiatric and rehabilitation facilities, among other things. CMS first proposed the rule in April and then incorporated public feedback into the final version.

The rule alters the Medicare Promoting Interoperability Program by instituting a new performance-based scoring system with fewer objectives, which CMS says will consequently eat less provider time. It also removed certain measures that don’t relate to interoperability and electronic data exchange. The rule also finalizes electronic health record (EHR) minimum reporting periods, including for opioid e-prescribing.

What’s more, CMS cut 18 and de-duplicated 25 meaningful measures for care quality, removing “unnecessary, redundant and process-driven” benchmarks.

For more information on the rule, read the document or check out this fact sheet.

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