The CMS on Wednesday released final rules that cut some of the regulatory mandates for Medicare and Medicaid providers, but discharge planning requirements for hospitals, critical access hospitals and home health agencies.
The agency's new burden rule relaxes staffing requirements and $843 million in savings in the first year, amounting to more than $8 billion in reduced costs over 10 years. It's part of the CMS' Patients Over Paperwork initiative, which the agency created in 2017 as a response to President Donald Trump's request to cut red tape.
Most notably, it lets health systems share a single, centralized staff for quality assessment, performance improvement and infection control programs across several hospitals. Health systems were previously required to have separate staff for each certified hospital, which hurt some small hospitals and other providers.
The rule also makes it easier for transplant centers to get reapproved for Medicare by eliminating the requirement that they resubmit data. The CMS said the change will improve access to organ transplants by removing the data submission requirements. The agency claimed that the previous regulations were so burdensome, some transplant programs avoided providing operations for selected patients and led to a number of organs getting tossed out.
During a call discussing the new rules, a CMS official said that some organs were never transplanted because transplant programs were worried about submitting data about organs from older or sicker donors. They thought it would hurt their standing with the CMS, even though those organs would have delivered enormous health benefits to potential recipients.
Hospitals also will be able to conduct reviews of their emergency preparedness plan every other year rather than annually. The rule provides additional regulatory relief for home health agencies, ambulatory surgical centers and critical access hospitals.
"This final rule brings a common sense approach to reducing regulations and gives providers more time to care for their patients, while reducing administrative costs and improving health outcomes," CMS Adminsitrator Seema Verma said in a statement on Thursday.
The discharge planning rule requires hospitals and critical access hospitals to evaluate patients that are likely to experience adverse health consequences and create a discharge plan if necessary. They must also assess patients for discharge planning if a patient, their representative or physician requests it. Hospitals, critical access hospitals and home health agencies will need to provide specific medical information when they transfer patients to another facility.
The rule change aims to give patients more information about post-acute providers, such as quality measures so that they can make informed choices about their care transitions. Providers will have to consider patient health objectives and care preferences during the discharge planning process to make sure patients get the care they want. Hospitals will also need to give patients electronic access to their health records. It's part of the CMS' mission to expand interoperability across healthcare settings to ensure that patients' health data is accessible and shared across providers.
"Today's rule is a huge step to providing patients with the ability to make healthcare decisions that are right for them, and gives them transparency into what used to be an opaque and confusing process," Verma said in a statement.
Hospitals and home health agencies will spend an estimated $215 million per year overall to comply with the discharge planning changes. Plus, an additional $46.5 million in one-time costs, the CMS said.
The CMS proposed the rule in 2015 to bring the discharge planning requirements into closer alignment with current practice, improve patient quality of care and outcomes, and reduce complications and readmissions.
