In response to the Centers for Medicare & Medicaid Services’ (CMS) request for information on CMS flexibilities and efficiencies, the American Hospital Association (AHA) is calling on the agency to further reduce regulatory burdens on hospitals and health systems by cancelling Stage 3 of the meaningful use program.
In addition, AHA is urging CMS to suspend the star ratings from the Hospital Compare website, suspend electronic clinical quality measure (eCQM) reporting requirements and reduce the other regulatory requirements associated with the EHR program.
In the letter, written by Thomas Nickels, AHA’s executive vice president, government relations and public policy and addressed to Seema Verma, CMS Administrator, AHA officials contend that the regulatory burden facing hospitals “is substantial and unsustainable.” “One small example of the volume of recent regulatory activity, in 2016, CMS and other agencies of the Department of Health and Human Services (HHS) released 49 hospital and health system-related rules, comprising almost 24,000 pages of text. In addition to the sheer volume, the scope of changes required by the new regulations is beginning to outstrip the field’s ability to absorb them,” AHA wrote in the letter.
Drilling down into AHA’s requests, regarding cancelling Stage 3 of the Meaningful Use program, AHA officials contend that hospitals already face “extensive, burdensome and unnecessary ‘meaningful use’ regulations from CMS that require significant reporting on use of electronic health records (EHRs) with no clear benefit to patient care. These excessive requirements are set to become even more onerous when Stage 3 begins in 2018. They also will raise costs by forcing hospitals to spend large sums upgrading their EHRs solely for the purpose of meeting regulatory requirements.”
AHA also says CMS should institute a 90-day reporting period in every future year of the program, eliminate the all-or-nothing approach and gather input from stakeholders on ways to further reduce the burden of the meaningful use program from current requirements.
AHA also wants CMS to suspend the hospital star ratings on its Hospital Compare website due to the organization’s ongoing concerns about CMS’s “flawed” metholodogy. “Our concern is amplified by the fact that further analysis performed since the star ratings were first released show that substantive errors were made in executing CMS’s chosen methodology. As a result, far too many hospitals have been incorrectly classified into star rating categories that are different than those that should have been assigned.”
AHA also contends that hospitals have spent significant time and resources to revise certified EHRs to meet CMS’s eCQM requirements for 2016, “with no benefit for patient care.” The organization is concerned with CMS’s proposals to increase the eCQM reporting requirement by 50 percent for 2017 and 2018, which, AHA says, “creates additional burden without an expectation that the data generated by EHRs will be accurate,” thus the organization suggests that CMS suspend all regulatory requirements that mandate submission of eCQM.
Further, AHA also recommends that CMS “undo” agency overreach on so-called “information blocking.” AHA officials explain: “Hospitals want to share health information to support care and do so when they can. But technology companies and the federal government have so far failed to create the infrastructure to make sharing information electronically easy and efficient. CMS went beyond statutory intent in asking hospitals to attest to three separate statements.”
The AHA is urging CMS to remove the second two attestations and keep only the statutory requirement that hospitals did not knowingly or willfully take action to limit or restrict the compatibility or interoperability of their EHRs.”
AHA also calls on CMS to expand Medicare coverage of telehealth services. This change should extend to the Medicare Advantage (MA) program so that MA plans can make services delivered via telehealth available more broadly to their Medicare enrollees,” AHA wrote in the letter.