During the recent Federation of American Hospitals 2019 Public Policy Conference, Centers for Medicare and Medicaid Services Administrator Seema Verma said in her speech that by 2027 Americans will likely have to spend more than 19 out of every hundred dollars on healthcare. Verma said rural Americans are facing even tougher challenges with 1 in 6 individuals lacking access to adequate healthcare and 40 percent of rural hospitals reporting negative operating margins.
“For millions of families, businesses, and particularly the federal government – this amounts to a cost crisis that could destroy our economy,” she said. “While we provide access to the best treatment in the world, we pay more for that care than any other country. Despite this, we have a greater number of avoidable hospital admissions than any other developed country and Americans are experiencing a growing prevalence of chronic disease.”
As a result, the CMS aims to transform the healthcare system into a patient-centered, consumer-driven model where providers compete for patients on the basis of lower cost and quality. To achieve this, they said they will focus on three main objectives: empowering patients, focusing on results, and unleashing innovation.
With interoperability and the seamless flow of data, FDA said providers can provide high-quality, coordinated care for their patients without repeating tests and ensuring safety and quality, resulting in better care and improved outcomes. And researchers can access complete and more robust data that will allow them to develop treatments and prevention measures, which would personalize healthcare and enhance evidenced-based treatment guidelines.
Last year FDA finalized the Meaningful Use programs to focus on interoperability and patient access to data and clinicians and hospitals are no longer incentivized or penalized based on just using an EHR. FDA eliminated thresholds and removed check-the-box measures in favor of scoring based on performance and results around interoperability and giving patients their data. Last year, it also launched Blue Button 2.0, a developer-friendly, standards-based API that enables Medicare beneficiaries to connect their claims data to secure applications, services and research programs that they trust and now over 1,500 app developers are building user-friendly apps that help seniors understand and access their data, like sharing their claims history with their doctor, and generating medication lists and reminders for care.
“Through the Interoperability and Patient Access proposed rule, for the first time, we are proposing that all health plans doing business in Medicare, Medicaid, and through the federal exchanges share health claims data and other important information electronically with their patients,” said Verma. “With all of those plans on board, by 2020, 85 million more patients will have access to their health claims information, in addition to the 40 million who already have access through Blue Button 2.0.”
Another key proposal is to require hospitals, through the conditions of participation in Medicare, to send electronic notifications to doctors and caregivers when a patient is admitted, discharged or transferred from the hospital. This proposal ensures that the patient’s entire care team has the information they need to better coordinate care for the patient.
