CMS Seeks To Ease Provider Burdens With New Payment Rules

October 2018

HIDA Government Affairs Update

By Linda Rouse O'Neill
Vice President, Government Affairs

The Centers for Medicare and Medicaid Services (CMS) has released a host of final payment rules, increasing payments to hospitals, skilled nursing facilities (SNFs), and other providers in 2019. The rules also contain a number of provisions designed to ease administrative burdens and lower providers’ cost of complying with regulations.

To assist healthcare distributors, HIDA Government Affairs has prepared several resources that outline the changes contained in CMS’s new payment rules. Here are some key insights from these resources.

Acute and long-term care hospitals
CMS announced it will increase payment rates for acute care hospitals by 1.85 percent and those of long-term acute care facilities by 1.35 percent. As part of the new payment rules, CMS will remove and de-duplicate a number of measures across the four quality and value-based purchasing programs.

The rules also contain a number of key changes and requirements for these providers. For example, acute care hospitals will now be required to list their standard prices online. The rule also changes the electronic health record program for these hospitals so that it has a smaller set of objectives. This move aims to give providers a more flexible, less-burdensome structure.

Skilled nursing facilities
CMS will increase payments for SNFs by 2.4 percent, according to its new payment rules. The agency will also implement the new Patient-Driven Payment Model, which focuses on the patient’s condition and care needs to determine reimbursement levels.

Other key changes in the SNF payment rule include updates to the SNF Value-based Purchasing program. These updates change the scoring methodology for low-volume SNFs, and also includes an exemption policy for extraordinary circumstances.

Inpatient rehabilitation facilities and hospices
CMS will increase payments to inpatient rehabilitation facilities (IRFs) by 1.35 percent and payments to hospices by 1.8 percent. The agency also announced that it will remove certain documentation requirements for IRFs and will reduce the number of quality measures each must report. These steps aim to achieve goals set out in the agency’s Meaningful Measures initiative, which seeks to improve patient outcomes while reducing the administrative burden on providers.

A common theme across these payment rules, in addition to the slight payment increase, is the agency’s efforts to reduce the reporting and administrative requirements on providers in different healthcare market segments. “We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” CMS Administrator Seema Verma comments on the agency’s website. “We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes.”

The agency continues to gather feedback on its regulations, so it is possible CMS will take further action to reduce the impact of existing requirements. If you have any questions, or would like to access HIDA’s resources on CMS’s payment rules, 

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