Health Reform WK-EDGE CMS initiatives provide patients with EHR control
Wednesday, March 21, 2018

CMS initiatives provide patients with EHR control

By Kathryn S. Beard, J.D.

As part of its "Patients Over Paperwork" approach, CMS announced two initiatives that will give patients more control over their electronic health records (EHR), and will be asking private insurers, including those that offer Medicare Advantage plans and qualified health plans (QHPs) on the federally facilitated exchange, to also release data. The Trump Administration’s MyHealthEData initiative, led by the White House Office of American Innovation with HHS participation, will break down barriers that prevent patients from having access to and control of their EHR. CMS also improved the Medicare Blue Button option to "Blue Button 2.0," which will allow beneficiaries to use their claims data on health-management applications or share it with doctors to improve clinical decision-making.

CMS Administrator Seema Verma announced the Blue Button improvements and MyHealthEData initiative in a speech at the Healthcare Information and Management Systems Society (HIMSS) annual conference. Noting her concern with "how seldom the patient is mentioned in discussions around value-based care," Verma explained that interoperability is key to improving health outcomes. The agency has plans to overhaul Evaluation and Management code documentation requirements to make it easier for providers to use EHRs and allow "every patient and their doctor [to] receive free and timely access" to the data.

The Medicare Blue Button, first launched in 2010, gives patients access to claims data in a PDF file, but, according to Verma, provides no context or other assistance in understanding what the data means. The 2.0 update, described as developer-friendly and standards-based, will enable beneficiaries to connect the claims data to secure and trusted applications, services, and research programs. The agency plans to require application developers to obtain approval before they may access beneficiary data, and more than 100 organizations have already joined the CMS developer preview program. CMS will also be working with states to help make Medicaid claims data similarly available to beneficiaries.

These changes and innovations are currently only for providers and suppliers involved in the federal health care programs. To help make sure as many individuals as possible have access to and control of their EHR, Verma called on all private insurers to give patients electronic claims data. Although the agency cannot require all insurers to comply, it will evaluate its partnerships and relationships with private health insurers, including those who offer Medicare Advantage or Prescription Drug Plans, and those who participate in the exchanges created by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). It will also shift focus on Stars rating programs’ quality measures toward patient access to data.

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