CMS finalizes overhaul to meaningful use program

The U.S. Centers for Medicare and Medicaid Services (CMS) has published a final rule for its Inpatient Prospective Payment System and the Long-Term Care Hospital Prospective Payment System that includes its proposed overhaul of the meaningful use program.

As proposed in April, the meaningful use program -- now called the Medicare and Medicaid Promoting Interoperability Programs -- has been overhauled to make the program more flexible and less burdensome, emphasize measures that require the exchange of health information between providers and patients, and incentivize providers to make it easier for patients to obtain their medical records electronically, according to CMS.

"The policies in the FY 2019 IPPS/LTCH PPS final rule will bring us closer to the agency's goal of creating a patient-centered healthcare system by increasing price transparency and fluid information exchange -- essential components of value-based care -- while also significantly lifting the administrative burden on hospitals so they can operate with greater flexibility and patients have the information they need to make decisions about their own care," CMS said in a statement.

The final rule also reiterates the requirement for providers to use the 2015 edition of certified electronic health record technology in 2019 as part of demonstrating meaningful use to qualify for incentive payments and avoid reductions to Medicare payments.

"This updated technology includes the use of application programming interfaces (APIs), which have the potential to improve the flow of information between providers and patients," CMS said. "APIs can enable patients to collect their health information from multiple providers and incorporate it into a single portal, application, program, or other software. This will support a patient's ability to share their information with another member of their care team or with a new doctor, which can reduce duplication and encourage continuity of care."

The 2019 IPPS/LTCH PPS final rule also includes an average payment increase of approximately 3% for acute care hospitals, reflecting rate updates required by law and payments for new technologies and uncompensated care, CMS said. In addition, the rule updates geographic payment adjustments for IPPS hospitals. CMS said that it has begun the process of making geographic payments more equitable for rural hospitals by allowing the imputed wage index floor to expire for all-urban states.

CMS also updated the LTCH PPS standard federal payment rate by 1.35%. Overall, CMS projects that LTCH PPS payments will increase by approximately 0.9%, or $39 million, in the 2019 fiscal year as a result of changes in the final rule.

In other policy changes, the 2019 IPPS/LTCH PPS final rule also removes "unnecessary, redundant, and process-driven quality measures" from several quality reporting and pay-for-performance programs. A total of 18 measures have been removed, and another 25 measures have been deduplicated across the four hospital pay-for-reporting and value-based purchasing quality programs, CMS said.

The final rule can be found on the Federal Register website.

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