CMS

The Centers for Medicare & Medicaid Services (CMS)

CMS Encourages Home Health Agencies To Adopt Health IT

CMS issued a proposed rule for the 2016 Medicare home health prospective payment system that encourages home health agencies to accelerate their adoption of health IT, Health Data Management reports (Goedert, Health Data Management, 7/8).

Details of Proposed Rule

According to AHA News, the proposed rule would reduce home health payments by 1.8% from 2015 levels (AHA News, 7/6). The proposal also would impose a value-based purchasing model on all Medicare-certified home health agencies in nine states as part of a pilot program.

In addition, the proposal would:

  • Enforce a 1.72 percentage point cut in calendar year 2016 and CY 2017 to the standardized 60-day episode payment rate (Health Data Management, 7/8); and
  • Establish the third year of a four-year "rebasing" of the standardized 60-day home care episode rate in an effort to recover overpayments (Dickson, Modern Healthcare, 7/7).

Health IT Implications

Citing the Office of the National Coordinator for Health IT's interoperability roadmap and the draft 2015 Interoperability Standards Advisory, CMS in its proposed rule encourages home health agencies to use electronic health records and health information exchange (Durben Hirsch, FierceEMR, 7/7).

CMS notes that doing so would result in greater success for the organizations, adding that "effective adoption and use of health information exchange and health IT tools will be essential as these settings seek to improve quality and lower costs through initiatives such as value-based purchasing."

The agency adds, "As adoption of certified health IT increases and interoperability standards continue to mature, HHS will seek to reinforce standards through relevant policies and programs" (Health Data Management, 7/8).

Source: iHealthBeat, Wednesday, July 8, 2015

CMS To Give Private Sector Access to Medicare Program Data

CMS announced that it will soon give the private sector access to troves of Medicare data, MedCity News reports.

CMS acting Administrator Andy Slavitt made the announcement at Health Datapalooza, an event promoting transparent and accessible health care data (Versel, MedCity News, 6/3).

The move marks a change from CMS' longtime policy of barring private-sector researchers from using CMS data for commercial reasons (Versel, MedCity News, 6/3).

In a statement, Niall Brennan, chief data officer at CMS and director of the agency's Office of Enterprise and Data Analytics, said, "Historically, CMS has prohibited researchers from accessing detailed CMS data if they intended to use it to develop products or tools to sell" (Miliard, Healthcare IT News, 6/2).

Slavitt said the decision to open up the data to the private sector aims to "shak[e] up health care innovation and se[t] a new standard for data transparency" (Walsh, Clinical Innovation & Technology, 6/2). Further, the policy change aims to spur the development of new technologies, such as predictive modeling tools (Healthcare IT News, 6/2).

Details of Announcement

Under the new policy, set to take effect in September, data will be accessible through CMS' Virtual Research Data Center, which includes Medicare fee-for-service claims data (Kalish, Health Data Management, 6/2).

Researchers will be vetted before they are given access (Mazmanian, FCW, 6/2).

According to Health Data Management, researchers will be able to analyze the data in a "secure CMS environment." Specifically, CMS will bar researchers from removing patient-level information from the database. Instead, they will be able to download aggregated, privacy-protected reports.

While the data will be de-identified to protect patient identities, health care providers will be identifiable, according to CMS (Health Data Management, 6/2).

According to Slavitt, researchers and entrepreneurs also will be able to combine the CMS data with other data sources (FCW, 6/2).

Reaction

In a release, the Healthcare Leadership Council lauded CMS' announcement as a "critical step" toward transforming the U.S. health care system.

Council President Mary Grealy said, "Our ability to build a[n] ... evidence-based, innovative health care system hinges on information," adding, "By making this data accessible to the private sector, CMS is making it possible for this process to accelerate" (Healthcare Leadership Council release, 6/2).

Other Data Sharing Changes

Meanwhile, Slavitt also announced that CMS will begin sharing data on a quarterly basis, rather than annually.

In addition, all data submitted to CMS will have to be in a machine-readable format to help drive consumer engagement (Health Data Management, 6/2).

Source: iHealthBeat, Wednesday, June 3, 2015

Interoperability, Usability, and the ONC 2015 Edition Certification

"Satisfaction and usability ratings for certified electronic health records (EHRs) have decreased since 2010 among clinicians across a range of indicators.”

This announcement was made 5 years ago the 2013 Healthcare Information and Management Systems Society (HIMSS) Conference & Exhibition by Michael S. Barr, MD, MBA, FACP.

CMS Seeks Small IT Vendors To Take Over HealthCare.Gov Operation

CMS Seeks Small IT Vendors To Take Over HealthCare.Gov Operation

CMS is soliciting information from small IT service vendors that might be interested in taking over the operation of HealthCare.gov after the agency's one-year contract with Accenture expires, according to documents released Thursday, FCW reports.

Background

In January, CMS announced that it was awarding Accenture a one-year contract to oversee HealthCare.gov and prepare for next year's open enrollment period.

The announcement came one day after CGI Federal -- the previous lead contractor on the federal health insurance exchange website -- said its three-year contract would not be renewed when it expired on Feb. 28 (iHealthBeat, 1/13).

Notice Details

The "sources sought" notice, published on the Federal Business Opportunities website, outlines qualities CMS will be looking for when it begins reviewing candidates to fill the contracting slot (Mazmanian, FCW, 4/21).

see https://www.fbo.gov/?s=opportunity&mode=form&id=cb602ee639f1545f87acf2ce...

According to Modern Healthcare, Accenture would not qualify if it sought to continue its working relationship with CMS because the company earned $7.13 billion in 2013.

In the notice, CMS asks interested and eligible small vendors -- defined as those with annual revenues under $25 million -- to submit their information by May 2.

A small vendor could potentially be allowed to team up with a larger company for the available contract, but the larger company would be regarded as a subcontractor and will be permitted to work on no more than 49% of the work.

Next Steps

If the response rate from small vendors falls below expectations, CMS could issue a general request for formal proposals, which would permit contract bids from any company, including Accenture.

According to Modern Healthcare, Accenture would train any replacement during a 60-day transition period before handing over operational control.

Accenture's Performance

Some industry experts note that CMS' solicitation for information does not necessarily signify that the agency is dissatisfied with Accenture's work.

Kev Coleman, head of data and research at HealthPocket, said the two entities' relationship would only be determined by examining the exchange's security and performance in November, when the second open enrollment period begins (Dickson, Modern Healthcare, 4/21).

Source: iHealthBeat, Tuesday, April 22, 2014

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