On February 11, 2019, the Centers for Medicare and Medicaid Services (CMS) issued proposed regulations to support MyHealthEData initiatives to improve patient access, and advance electronic data exchange and care coordination through the healthcare system. The purpose of the proposed regulations is to make patient data more useful and transferable through open, secure, standardized and machine-readable formats while reducing restrictive burdens on providers. In addition to these proposals, CMS released two Requests for Information (RFIs) to obtain feedback on interoperability and health information technology adoption in Post-Acute Care (PAC) settings. Among other changes, CMS proposes to change Conditions of Participation (CoPs) of the Medicare Program on discharge planning. These changes, if finalized, will apply to hospitals and critical access hospitals (CAHs).
Current CoPs for hospitals and CAHs include health and safety standards that are intended to help ensure effective care transitions for patients during the discharge process. CMS says that electronic notifications of the status of patients are a “proven tool” to improve transitions of care between settings and patient safety. While using these notifications is low-cost and easy to achieve using any electronic health record system, according to CMS, many hospitals have not developed capabilities and/or utilized these systems to send notifications to other providers and facilities to which they transition patients.
Consequently, CMS proposes to require hospitals, psychiatric hospitals and CAHs that participate in the Medicare Program to send electronic notifications when patients are admitted, discharged or transferred. If finalized, these notices may be especially helpful to home care providers. Anecdotally, providers have expressed concern that they do not know when patients are discharged so that they can resume care, if appropriate. A mandate for hospitals to provide such notice may assist home care providers of all types to provide better continuity and quality of care for their patients who have been hospitalized.
CMS also included several requests for information in the proposed regulations. Specifically, CMS is looking for ways to coordinate care across different healthcare settings while advancing interoperability. CMS is also asking for input on how it can promote widespread adoption of interoperable health IT systems for use across healthcare settings, such as post-acute care, including individuals receiving home and/or community-based services. Commenters who respond to the RFIs should provide clear and concise proposals that include data and specific examples. CMS will actively consider all input when developing future regulatory proposals and guidance.
CMS will undoubtedly continue to work at the issue of helping to ensure more effective care transitions across the continuum of care. Providers must get on board!