CMS considering eCQMs for OPPS reporting

The Centers for Medicare & Medicaid Services, yet again, has used its payment rules as a vehicle for advancing electronic health records and health information exchange, this time in its final outpatient prospective payment system (OPPS) rule for 2015.

The final rule with comment period, published in the Federal Register Nov. 10, reiterates CMS' desire that outpatient facilities and ambulatory surgical centers adopt EHRs, floating the feasibility of requiring electronic clinical quality measures (eCQMs) for the hospital outpatient quality reporting program and the ambulatory surgical center reporting program in the future.

In what has become familiar language in provider payment rules, CMS outlines its view on EHRs:

"The Department is committed to accelerating health information exchange (HIE) through the use of electronic health records (EHRs) and other types of health information technology (health IT) across the broader care continuum through a number of initiatives including: (1) Alignment of incentives and payment adjustments to encourage provider adoption and optimization of health IT and HIE services through Medicare and Medicaid payment policies; (2) adoption of common standards and certification requirements for interoperable health IT; (3) support for privacy and security of patient information across all HIE focused initiatives; and (4) governance of health information networks," the agency states in the rule.

CMS acknowledges in the rule that ASCs, in particular, had low levels of EHR use, and that eCQMs were not quite ready for prime time:

"We recognize that much work needs to be done before the adoption of electronic clinical quality measures. However, we also believe that implementation of electronic clinical quality measures will ultimately reduce provider burden and facilitate care coordination and patient engagement," the agency says. "We will weigh and balance these concerns when we propose to adopt electronic clinical quality measures in the future."

The comment period ends Dec. 30.

The payment rule is the latest in a series of CMS rules that affect or require EHRs but are not directly related to the Meaningful Use program. CMS had also floated the idea of requiring eCQMs for inpatient rehabilitation hospitals (IRF) in its final 2015 IRF payment rule, issued earlier this year. The final IPPS rule tweaks the Meaningful Use program; the final physician payment rule requires the use of certified EHR technology for reimbursement of chronic care management.  

To learn more:
- read the rule (.pdf)

Suggested Articles

Roche, which already owned a 12.6% stake in Flatiron Health, has agreed to buy the health IT company for $1.9 billion.

Allscripts managed to acquire two EHR platforms for just $50 million by selling off a portion of McKesson's portfolio for as much as $235 million.

Artificial intelligence could help physicians predict a patient's risk of developing a deadly infection.