ICYMI: Notes from the field for October 2019
This month saw many policy updates and changes, as well as new reports on the progress of value-based initiatives. Here’s what we were thinking about this month—what caught your attention?
CMS policy updates and changes
- With more demands piling on clinicians, the issue of physician burnout is becoming a big and costly issue. CMS released Omnibus Burden Reduction and Discharge Planning final rule to try to mitigate the issue and improve the planning process for discharges from hospitals to post-acute facilities.
- With the number of physicians who electronically prescribe controlled substances on the rise, there’s hope that directly integrating opioid prescription information into the EHR will improve patient safety. By reducing barriers to electronic prescribing, the Office of the National Coordinator for Health Information Technology also seeks to deter diversion and fraud.
- A new executive order on Medicare seeks to make it simpler for patients to find a doctor accepting Medicare insurance. By removing barriers that currently exist regarding private contracting, the order seeks to allow patients and doctors to negotiate their own deals outside of Medicare. Opponents say the order opens the door for costly unintended consequences.
Improving coverage
- In the eighth year of the value-based purchasing program, a majority of participants are on track to receive increased Medicare payments for the 2020 fiscal year. While this is good news, it’s roughly on par with last year’s rate of success. Rural hospitals this year significantly outperformed their urban counterparts.
- Recent oncology cost trend data reveal some disturbing truths. What Medicare pays for cancer care may be unsustainable and change is necessary if the program is to remain solvent.
- Last week, the House voted unanimously to pass the Dignity in Aging Act, a bipartisan proposal to reauthorize the Older Americans Act that increases funding for vital programs that help aging Americans live independently and with dignity. The OAA currently serves about 11 million older Americans, including three million older Americans who regularly rely on OAA programs to meet their basic needs.
Improving overall care quality
- Accelerating the shift to success in value-based care will require a key stakeholder: the chief financial officer. As hospitals and health systems look to take on more risk, there’s a hiring race on to find CFOs who can effectively increase adoption while protecting margins.
- The U.S. Digital Service was born out of the poorly executed launch of the Healthcare.gov website to enroll people in the newly passed ACA. Since then, efforts have been focused on modernizing legacy IT systems to support the move to value-based care and meeting CMS requirements. The U.S. Digital Service has been functioning like a start-up within the government and is delivering real results.
- The Patient-Driven Groupings Model will dramatically change home health reimbursement beginning in January 2020. Similar to the Medicare Prospective Payment System, there will be a consolidation of providers. Effective change management will be a key driver for the organizations that will succeed during the transition to PDGM.
- CMS announced more than 1,500 participating hospitals will receive about $1.9 billion in bonuses for fiscal 2020 under CMS’ Hospital Value-Based Purchasing Program. The results are about the same as last year, with about 55% of participants scoring bonuses.