Reference no: EM133701347

Assignment:

2019 Program Requirements Medicare

In the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-term Care Hospital (LTCH) Prospective Payment System Final Rule, CMS made changes to the Promoting Interoperability Programs for Medicare eligible hospitals, critical access hospitals (CAHs), and dual-eligible hospitals attesting to CMS. The final rule adopted policies to continue the advancement of certified electronic health record technology (CEHRT) utilization, reduce burden, and increase interoperability and patient access to their health information. Eligible hospitals and CAHs must successfully demonstrate meaningful use of CEHRT to avoid reductions to their Medicare payments. Some of these changes will affect 2019 reporting. For more information on these and other changes, review the final rule and fact sheet. CMS will be updating the Promoting Interoperability Programs website with additional 2020 program requirements details in the coming weeks.

2015 Edition Certified EHR Technology

Beginning with the EHR reporting period in calendar year 2019, participants in the Medicare Promoting Interoperability Program are required to use 2015 Edition CEHRT. This requirement will be beneficial to health care providers to move to more up-to-date standards and functions that better support interoperable exchange of health information and improve clinical workflows. The 2015 Edition CEHRT did not have to be implemented on January 1, 2019. However, the functionality must be in place by the first day of the EHR reporting period. The eligible hospital or CAH must be using the 2015 Edition functionality for the full EHR reporting period. In many situations the product may be deployed, but pending certification.

Scoring Methodology

In the FY 2019 IPPS LTCH final rule, CMS finalized changes to the scoring methodology to shift to a performance-based scoring methodology with fewer measures, instead of the previous threshold-based methodology. CMS believes this methodology will encourage hospitals to push themselves on measures that are most applicable to how care is delivered to patients, instead of increasing thresholds on measures that may not be as applicable to an individual hospital.

Appraise and critique the rule changes for impact on practice and nursing:

• How has the final rule evolved from meaningful use to interoperability?
• Had you provided comments on the rule, what changes would you have recommended?
• Which elements would you keep?
• What further recommendations do you have for CMS to consider in future updates to the rule?
• How will the Final Rule positively impact practice and nursing?