A senior official at the Centers for Medicare and Medicaid Services predicts 2018 will mark a notable shift in healthcare regulation.
“2018 is going to be a significant year in terms of regulatory and burden reduction,” CMS' Chief Medical Officer Kate Goodrich, M.D., told audience members at a listening session hosted by CMS and the Office for the National Coordinator for Health IT (ONC) on Thursday.
Reducing physician burden is a top priority for the Department of Health and Human Services (HHS) and the Trump administration as a whole. In an economic report (PDF) released earlier this week, the White House singled out the EHR reporting requirements as one reason that small physician groups and solo providers have been forced to merge with larger hospitals, stifling competition.
CMS has launched specific campaigns directed at reducing documentation requirements and talking with physicians about regulatory reform. ONC, meanwhile, is acutely focused on EHR interoperability and usability. During the CMS/ONC listening session, attendees peppered officials with the real-world burdens of health IT regulation.
But Goodrich said the agency has already targeted “seriously low-hanging fruit,” most of which can be resolved without high-tech gadgetry. Even small technical changes that seem “stupid” at first glance can be addressed through guidance or subregulatory efforts.
For example, CMS recently made a change to its state survey process to allow providers to submit a plan of correction on a Word document rather than the survey form.
“Why we never did that before, I don’t know,” she said.
Other efforts have been more technically robust. The new data submission website for the Quality Payment Program, officially launched in January, was a key part of the agency’s effort to reduce the reporting burden. CMS has also been testing out the use of mobile apps for QPP data submission as part of its “API-first strategy.”
Goodrich said the apps have already received “incredibly positive feedback.”
CMS has tweaked it documentation submission system for recovery contractors, allowing providers to respond to documentation requests with structured data formats pulled from EHRs rather than limiting them to PDF documents.
For those recovery contractors, the metadata buried in those EHRs holds a lot of promise, particularly for payment categories like physical therapy that rely on the time-based component, said Melanie Combs-Dyer, the director of provider compliance at the CMS Center for Program Integrity. She said the agency plans to test the use of metadata in one Medicare Administrative Contractor jurisdiction.
Broadly, Combs-Dyer emphasized the importance of provider-to-provider data exchange that can streamline physician workflow and eliminate the need for cumbersome paper records.
“I can’t believe we got to 2018 and the provider community is still reliant on the fax machine,” she said.