CMS: "Meaningful Use" Is Out, "Interoperability" Is In

In an effort to make good on its plans to give patients more control over their health information as well as reduce the number of quality measures healthcare providers have to report, CMS announced changes in both of those areas Tuesday.

CMS said it is renaming the Meaningful Use program to “Promoting Interoperability.” The language change also will force providers to use the 2015 edition of certified electronic health record technology next year as part of demonstrating meaningful use to qualify for incentive payments and avoid reductions to Medicare payments.

In addition, CMS is requiring hospitals to post prices; before, they had an option to post them or give them out if asked.

Another proposed rule change would reduce the number of quality measures acute care hospitals are currently required to report. CMS said providers would save $75 million and 2 million extra work hours by removing 25 measures that are either duplicative or “topped out.”

The proposed rule changes falls under updates to Medicare payment policies and rates under the Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System.

“We seek to ensure the healthcare system puts patients first,” said CMS administrator Seema Verma in a statement. “Today’s proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers. We envision a system that rewards value over volume and where patients reap the benefits through more choices and better health outcomes.”

The proposed policies begin implementing HHS' "MyHealthEData" initiative through several steps to strengthen interoperability or the sharing of healthcare data between providers, CMS said.

CMS is also seeking public comment in several areas:

• What price transparency information stakeholders would find most useful
• How to help hospitals create patient-friendly interfaces using application programming,which would also facilitate sharing between providers and hospitals.

CMS is also seeking public comment on the best way to price the pioneering chimeric antigen receptor (CAR) T‑cell therapy. For now, CMS is proposing that for FY 2019, CAR T-cell therapy gets reassigned to a higher-weighted Medicare-severity diagnosis related group (MS-DRGs) related to bone marrow transplants.

At the same time, both companies that make the treatments, Novartis and Gilead, are seeking to have new technology add-on payments added to the therapies. CMS is also exploring a new MS-DRG code altogether.

Currently, CAR T treatment, which can cost between $373,000 to $475,000 for a 1-time treatment depending on the drug, is being managed in new, different reimbursing arrangements.

The Washington Post noted Wednesday that the updates to Medicare include $1.5 billion to the funds for so-called disproportionate share payments to protect hospitals from the expense of treating patients who cannot pay their bills. The increase is a sign that US expects an increase in uninsured patients.