CMS finalizes hospital quality reporting, interoperability changes

With help from Arthur Allen (@arthurallen202), Darius Tahir (@dariustahir) and Sarah Owermohle (@owermohle)

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Quick Fix

The ONC advisory committee’s U.S. Core Data for Interoperability task force meets virtually Friday — till then, here’s what we’re tracking.

— CMS finalizes hospital quality reporting, interoperability changes: The agency cemented a handful of updates to the hospital quality reporting and the Promoting Interoperability programs.

— Interest groups try to make their mark on surprise billing legislation: Congress couldn’t close the loop before summer break on its surprise medical bill effort, so powerful interest groups have more time to shape it.

— Almost 32 million patients’ records breached in 2019: The number of patients affected by data breaches has more than doubled since 2018, according to a surveyfrom health IT security company Protenus.

eHealth Tweetof the day: Vinny Arora MD MAPP @FutureDocs: Keys from inspiring@toyinajayidoc@cityblockhealth on trust: measure what matters. Stop focus on “Lazy proxies” (buildings, reputation, rankings) Our patients are experts on their lives- LISTEN Rediscover magic of human connection Amplify the unheard voices#ABIMF2019

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Driving the Day

EHR REPORTING PERIODS, ECQMS CHANGES IN CMS RULE — The latest of CMS’ recent battery of rules last week finalized changes to the agency’s hospital quality reporting program, including the adoption of a new measure establishing what constitutes the safe use of opioids and concurrent prescriptions. CMS also finalized a 90-day EHR reporting period in 2021 for the Medicare and Medicaid EHR Incentive Programs — recently rebranded as “Promoting Interoperability” — to give hospitals more flexibility to build out and update their EHRs, a spokesperson told Morning eHealth.

... The agency also said it planned to align the clinical quality measure reporting requirements for Promoting Interoperability with the existing hospital inpatient quality reporting program, which pays hospitals for reporting on clinical measures and reduces the payments to those facilities that miss certain benchmarks.

...CMS also made moves to encourage the development of new medical devices and antibiotics that combat serious infectious diseases. If the FDA designates a new device a breakthrough therapy — or a substantial improvement on existing technology — CMS will no longer require developers to demonstrate improvements to qualify for an add-on payments, ideally speeding up access to Medicare and Medicaid beneficiaries.

Similarly, CMS would no longer require new antimicrobial drugs that fight serious infections to meet the “substantial clinical improvement” bar if they have already been designated needed drugs, known as Qualified Infectious Disease Products, by the FDA. In a call with reporters, CMS Administrator Seema Verma said drug-resistant infections are a public health crisis and the alternative pathway would encourage new therapies.

In Congress

CONGRESS’ ‘SURPRISE’ BILLING EFFORT ON HOLD UNTIL THE FALL — Lawmakers failed to finish their monthslong bipartisan effort to hold patients harmless from sometimes staggering “surprise” medical bills before August recess, but that doesn’t mean powerful health interests are sitting back, our colleagues Rachel Roubein and Adam Cancryn report.

..."I think August is going to serve as a strong education opportunity, from both our commercial advertising, our digital ad reach and, of course, our physicians directly meeting their members and, of course, us talking to policy staffers on the Hill,” Sherif Zaafran, chairman of Physicians for Fair Coverage, which supports having independent arbiters help settle billing disputes between providers and health plans, told POLITICO.

...Earlier this summer, the Senate HELP Committee approved a health costs package, S. 1895 (116) that addressed surprise medical bills and established a federal benchmark payment aimed at settling billing disputes that was tied to median in-network rates in certain areas; A bipartisan group of senators led by Bill Cassidy (R-La.) has advocated for resolving payment disputes through the arbitration process instead. In the House, the Energy and Commerce Committee approved a bill, H.R. 2328 (116)laying out an arbitration option for cases in which the median in-network rate paid to providers exceeds $1,250.

Sen. Lamar Alexander (R-Tenn.) said last week that Senate HELP Committee and House Energy and Commerce leaders had met, and that the legislation “is looking like a train that will get to the station when Congress reconvenes in September.”

But other House committees have signaled an interest in taking up the issue this fall, Rachel and Adam write. “We’re examining it, there are competing discussions about jurisdiction ... but we’re certainly very interested in the subject,” Ways and Means Chairman Richard Neal (D-Mass.) said.

Cybersecurity

SURVEY: HEALTH DATA BREACHES SURGE — A total of 31,611,235 patient records have been exposed in the first six months of 2019, and about 60 percent of those were due to hacking, according to a survey from health IT security firm Protenus. The roughly 32 million figure is up from 15 million in all of 2018, the company says.

Technology

MIT THROWS AI AT ALZHEIMER’S — Researchers at the Massachusetts Institute of Technology are developing a system they think can predict if patients will undergo cognitive decline from Alzheimer’s, according to a news release. The system predicts how patients at risk of the disease will perform on cognition tests up to two years into the future. The predictions could help inform drug choices and clinical trials, researchers say.

Health IT Business Watch

ICYMI: TELADOC SEES Q2 GAINS — Telehealth company Teladoc has seen virtual visits rise 70 percent to 908,000 in the second quarter of 2019, partly due to an uptick in behavioral health appointments, FierceHealthcare reports. The company’s revenue grew 38 percent, reaching $130.3 million in that quarter, officials said in an earnings call last week.

UBER DIPS INTO TELEHEALTH — Under a new agreement between Uber Health, medical supply company Henry Schein Medical and telemedicine company Medpod, clinicians will soon be able to dispatch colleagues to patients’ homes or send patients to other locations for virtual exams, MobiHealthNews reports.

DIRECTTRUST HITS 1 BILLION MARK — More than 1 billion messages have been sent and received using the Direct secure messaging system for exchanging health information, DirectTrust plans to announce today. The count started in 2014, when the organization began tracking transmissions.

APPLE WANTS YOU FOR ITS HEALTH APP — Health data wonks itching to head West might be in luck: the Cupertino giant is looking for a “senior level, energetic and self-driven software engineer” to focus on “upcoming features that rely on health data standards.” Among the qualifications: “Experience with health data standards and terminologies, including HL7 FHIR, SNOMED, LOINC, and others.”

What We're Reading

—Zoltan Istvan discusses the promises and challenges of artificial wombs in The New York Times.

—Stat’s Shraddha Chakradhar explores efforts to change the microbiomes in lab mice to better translate findings to humans.