- CMS on Wednesday issued final rules intended to reduce regulatory burden for providers and tweaked some discharge planning and emergency preparedness requirements.
- The agency said the burden reduction and efficiency rule would yield a net savings of $843 million in its first year and a bit more in years after. It includes provisions from three separate proposed rules, one from last year and two from 2016.
- The discharge planning rule, first proposed in November 2015, is projected to cost about $215 million a year. It requires hospitals to create discharge evaluations for patients at risk of adverse health consequences and for any patient whose family requests one.
The rules are part of broader push by CMS to cut red tape for providers and reduce redundancies. The agency launched its Patients Over Paperwork initiative in 2017 and has also pursued programs finding the best quality metrics to measure.
CMS Administrator Seema Verma said on a call with reporters Thursday some requirements "stand like a brick wall" for providers "yet do nothing to advance patient safety and health."
Verma said CMS will continue its efforts to eliminate unnecessary regulations and is working to set up an office dedicated to burden reduction. "There's more to come," she said.
CMS issued a request for information on reducing regulatory burden in June, building on a broader request when the 2017 initiative was launched. Commenters pushed for more streamlined quality reporting that is fair to rural and small facilities and also sought cuts in prior authorization requirements.
The American Hospital Association has said providers spend nearly $40 billion a year on government compliance, and such burdens can also add to provider burnout — another costly problem.
The final burden reduction rule cuts some requirements for transplant centers and ambulatory surgical centers seeking Medicare re-approval, lets hospitals review policies and procedures once every two years instead of annually and allows multi-hospital systems to use a single Hospital Quality Assessment and Performance Improvement Program.
That last requirement "will ease the strain on small facilities and allow them to draw from the clinical expertise of a larger system," Verma said.
The Ambulatory Surgery Center Association applauded the changes. "This rule will make it easier for ambulatory surgery centers to remain efficient and affordable providers of outpatient surgery without compromising their commitment to patient safety," the group said in a statement.
For the discharge rule, AHA noted CMS did not finalize a proposal to require hospitals establish a post-discharge follow up process for some patients discharged to the home. "Recognizing that hospitals already are doing this according to specific situations and patient needs, the agency encouraged providers to continue following evidence-based best practices to establish an appropriate process," AHA said.