Coalition of ACOs, IT organizations throw support behind a CMS data-sharing mandate

A group of predominantly ACOs says making data sharing a CoP "represents an important first step in forcing change to a system that has been too slow to evolve." (Getty/andrei_r)

A diverse group of accountable care organizations, insurers, patient advocacy and health IT companies want the federal government to require data sharing among providers to participate in Medicare.

The organizations didn’t stop there. They also urged the Centers for Medicare & Medicaid Services (CMS) to use other policy levers to drive interoperability by requiring the use of 2015 Edition Certified EHRs and aligning requirements in the Quality Payment Program, the Promoting Interoperability (currently known as Meaningful Use) and STAR ratings.

“We believe the time is right to move past the current rigid and siloed system into one prepared to take advantage of all the opportunities made available in our digital age,” the groups wrote in a letter (PDF) to CMS.

Free Daily Newsletter

Like this story? Subscribe to FierceHealthcare!

The healthcare sector remains in flux as policy, regulation, technology and trends shape the market. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

RELATED: CMS floats proposal tying medical records sharing to Medicare participation

The suggestion came in response to a request for information in the agency’s proposed hospital payment rule about including interoperability in Medicare’s Conditions of Participation (CoP). The letter was signed by dozens of ACOs, including several with providers ties like Beth Israel Deaconess Care Organization, BJC HealthCare ACO, and Saint Francis Healthcare Partners. It also included the Biden Cancer Initiative and Blue Shield of California.

Calling a policy that makes information sharing a CoP “a tremendous benefit to millions of Medicare and Medicaid patients across the country,” the organizations said hospitals should be required to release real-time data when a patient visits the emergency department, is discharged home or is transferred to another facility. Discharge instructions and summary of care should be available to patients within 24 hours, they added, and through a “third-party tool of their choice if desired.”

But the groups also said CMS should allow hospitals to meet the requirements over time and leverage existing tools like health information exchanges to gradually ramp up requirements.

RELATED: AHA ‘strongly opposes’ interoperability as a Medicare requirement

“We support the proposal to require data sharing related to readmissions, improved care coordination and quality, and a reduction in unnecessary or even dangerous care… because it represents an important first step in forcing change to a system that has been too slow to evolve in a way that puts the needs of patients first,” they wrote.

HIMSS, the nation’s largest health IT advocacy group, said (PDF) it is also supportive of exploring “all available policy levers to promote interoperability,” including CoP revisions. The group suggested that a “modified” version of the Trusted Exchange Framework and Common Agreement could be used to meet any potential CoP requirements.

This week, the American Hospital Association said it "strongly opposes" tying data sharing to CoPs, highlighting concerns about how surveyors would measure compliance and difficulties sharing medical information with post-acute care providers.

RELATED: CMS hints at Blue Button 2.0 mandates for Medicare Advantage plans in 2020

National health IT groups like College of Health Information Management Executives (CHIME) and the American Medical Informatics Association (AMIA) said the administration should establish policies around information blocking and the Trusted Exchange Framework before making data sharing a mandate.

Likewise, the Electronic Health Records Association (EHRA) said (PDF) tying interoperability to CoPs without fully fleshing out data sharing policies under the 21st Century Cures Act would increase the burden for hospitals and “subject them to vague or undefined requirements.”