New CMS Proposals Focus on Supporting Physicians, Improving Care

CMS seeks to change their current Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System.

The US Centers for Medicare and Medicaid Services (CMS) recently proposed a new payment rate and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.

The CMS believes that these proposed changes will improve care received by Medicare patients. They also said these changes are based on feedback from stakeholders, according to a press release from the CMS.

Due to concerns that pain management may influence patient survey responses in the Hospital Value-Based Purchasing program, CMS will remove the pain management questions. This should eliminate any pressure physicians may feel to prescribe pain medications.

Alternative questions regarding the provider’s communication regarding pain may be included at a later time.

CMS is also proposing to eliminate higher payments for treatment in a hospital outpatient department, rather than receiving care at a physician’s office. This practice, according to the press release, has encouraged some hospitals to create physician offices to receive higher payments. The reduced spending is estimated to be $500 million.

CMS also streamlined electronic health record (EHR) reporting requirements under another proposed rule to increase flexibility and support improved patient outcomes for hospitals participating in the Medicare EHR Incentive Program. The clinicians would only have to use a 90-day EHR reporting period opposed to the full calendar year, according to the CMS.

Additional quality measures are also proposed to be added to the OPPS and ASC payments that focus on improved patient care and enhanced requirements for organ transplant programs. These new updates would increase OPPS payments by 1.6% and 1.2% ASC payments, the CMS reported.

“The items in this proposal are designed to improve care and value when Medicare beneficiaries receive care in an outpatient setting,” said Andy Slavitt, Acting CMS Administrator. “Today’s proposed updates better support physicians in providing beneficiaries with the right care at the right time.”