By Rebecca Mayo, J.D.
CMS’s Patients over Paperwork initiative has made great progress in eliminating needlessly complex, outdated, or duplicative requirements that take clinicians’ focus away from patient care, so CMS is now asking the public for ideas about further improvements.
Through the Patients over Paperwork initiative, CMS aims to eliminate overly burdensome and unnecessary regulations and subregulatory guidance in order to allow clinicians and providers to spend less time on paperwork and more time on their primary mission of improving patients’ health. After seeing success in changes made in response to feedback received from the medical community, CMS is now asking the public to provide input on the areas where it believes CMS could improve flexibility and efficiency through the Medicare and Medicaid programs.
Patients over Paperwork. CMS launched the Patients over Paperwork initiative in 2017 to find opportunities to modernize or eliminate rules and requirements that were outdated, duplicative, or getting in the way of good patient care. The goal of the initiative was to increase quality of care, lower costs, improve Medicare and Medicaid program integrity, and make the health care system more effective, simple, and accessible. CMS solicited feedback from the medical community and received over 3,000 responses which resulted in 1,146 distinct burden topics to address. These topics included audits and claims, documentation requirements, health information technology, interoperability, provider participation requirements, quality measures and reporting, payment policy and coverage determinations, the physician self-referral law, and telehealth.
Successes of the initiative to date. CMS has resolved or is currently actively addressing over 80 percent of the actionable burden topics through changes to regulations, subregulatory guidance, operations, or direct education and outreach to providers and beneficiaries. CMS estimated that through regulatory reform alone, the health care system will save an estimated 40 million hours and $5.7 billion through 2021. Changes like the Patient Driven Payment Model for skilled nursing facilities will put quality of patient care over quantity of patient care and simplify patient assessments and paperwork, saving an estimated $2 billion over 10 years. Policies advancing Meaningful Measures has eliminated an estimated 79 overly burdensome, redundant, or low-value measures, resulting in a projected savings of $128 million and anticipated reduction of 3.3 million hours through 2020.
Request. As part of CMS’s efforts to continue to work to maintain flexibility and efficiency through the Medicare and Medicaid programs, CMS invited the public to submit ideas for regulatory, subregulatory, policy, practice and procedural changes to better accomplish those goals. CMS is especially interested in ideas on how to improve reporting and documentation requirements, coding and documentation requirements for Medicare and Medicaid payments, prior authorization procedures, policies and requirements for rural providers, clinicians, and beneficiaries, policies and requirements for dually enrolled beneficiaries, beneficiary enrollment and eligibility determinations, and CMS processes for issuing regulations and policies.
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