5 notes about CMS' interoperability program in 2019

In its latest Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule updates, CMS introduced a new performance-based scoring method for eligible hospitals and critical access hospitals under its promoting interoperability program.

CMS released updates to the IPPS final rule in August 2018. Through the promoting interoperability program, formerly referred to as the meaningful use program, CMS distributes incentive payments to healthcare providers that install EHRs effectively and use them to improve patient engagement and care coordination. The program comprises four main objectives: e-prescribing, health information exchange, provider-to-patient exchange and public health and clinical data exchange.

Five notes:

1. The finalized rule adds two new opioid measures to the program's e-prescribing objective: the verify opioid treatment agreement measure and the query of prescription drug monitoring program measure.

The new measures aim to reduce the risk of opioid use disorders, overdoses, inappropriate prescribing practices and drug diversion.

2. The finalized rule also modifies the program's health information exchange objective, building upon the existing request/accept summary of care and clinical information reconciliation measures. The new adjustments aim to reduce administrative burden and streamline reporting.

3. To reduce program complexity and burden, CMS removed the coordination of care through patient engagement objective as well as its three corresponding measures: secure messaging, patient generated health data and view, download or transmit.

4. CMS renamed the patient electronic access to health information objective to the provider patient exchange. The new objective includes one measure: provide patients electronic access to their health information.

5. The finalized rule introduced a new performance-based scoring method, which includes the four objectives and their new measures.

Eligible hospitals and critical access hospitals must report certain measures from each of the four objectives at the individual-measure level, and scores for each individual measure will then be combined to determine each hospital or CAH's total promoting interoperability program score. Each hospital or CAH can score up to 100 points.

To access the finalized rule, click here.

To view the full program scoring report, click here.

Editor’s note: Becker’s Hospital Review updated this article to better distinguish the release date of CMS' final rule, which the agency published in August 2018.  

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