Hospitals will see some of their leading regulatory concerns addressed in 2018 by CMS, according to Seema Verma, administrator of CMS. Verma noted that the Administration “is committed to reducing the regulatory burden on hospitals.”
Verma made her comments to the American Hospital Association (AHA) last week. The AHA’s president and CEO, Rick Pollack, noted that “hospitals are constantly challenged to implement new or revised regulations all while keeping track of the old ones, and doing so as they meet and maintain their core mission of providing high-quality service.” Pollack added that hospitals are increasingly frustrated with the time and resources being devoted to “pushing paper” that has little to do with improving the quality of care or access to services. (“2018 CMS Plans: New Models, Cuts to Measures, and Simplification of CoPs, HFMA Weekly, January 19, 2018)
CMS plans to address the following regulations:
- Conditions of Participation (CoPs), which are requirements that hospitals and other providers must meet to participate in Medicare and Medicaid. CMS plans new “deregulatory” rules on streamlining CoPs. AHA had requested that CoPs be evidence-based, aligned with other laws and industry standards, and flexible to support different patient populations and communities
- Reductions in the quality measures hospitals are required to report to CMS (under annual Medicare payment rules)
- Meaningful use requirements of the EHR Incentive Program
- Telehealth policy changes—strict limitations now exist, but CMS wants to increase its use within those legal strictures
- Stark Law and Anti-Kickback Statute to the extent that the current waiver program (for some new innovative care-delivery models) would be available outside demonstration projects and models; also to allow existing waivers to apply to similar arrangements with Medicaid or commercial payers
Welcome Back Value-Based Payment Models
CMS plans to take an aggressive approach to value-based payment. This surprised some industry experts because CMS had eliminated two mandatory bundled payment models in 2017 and made another one optional for participants in some markets.
Verma also talked about two issues that CMS plans to address: quality-reporting requirements in value-based models and the design of ACOs. She noted that CMS will be looking at AOs in a different way but did not elaborate.
(Source: “2018 CMS Plans: New Models, Cuts to Measures, and Simplification of CoPs, HFMA Weekly, January 19, 2018)
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