AGA and Alliance Talk with CMS Officials
Last week, AGA and the Alliance of Specialty Medicine hosted a physician roundtable discussion with senior officials from CMS and the Office of the National Coordinator (ONC) to specifically discuss both the value-based payment modifier (VBPM) and the electronic health records (EHRs) mandates and their impact on specialty medicine.
We were pleased to hear CMS and ONC officials state that they are working hard to harmonize reporting requirements across federal programs to make them less onerous and burdensome to physician practices. They recognize that the quality measures contained in the EHR meaningful use requirements are of limited value to specialists and that more flexibility is necessary to encourage specialty participation and quality improvement.
Dr. Patrick Conway, chief medical officer and director, Center for Clinical Standards and Quality, CMS, stated that physician and other clinical engagement is the key to success in quality improvement. He stressed the importance of registries in helping to collect and submit data for quality reporting as they are the fastest growing reporting option under the Physician Quality Reporting System (PQRS). The AGA Digestive Health Outcomes Registry® is a certified PQRS registry for reporting GI measures. We have found that physicians are more apt to properly report via a registry.
During the meeting, we raised an issue currently affecting many AGA members during their ASC CMS survey — GIs are being told to separate their office EHR from their ASC EHR, which is counterintuitive to HHS’s goal to integrate. ASCs are receiving citations for this issue and are forced to separate the EHRs, which causes significant changes in the process and structure of the EHR, as well as substantial costs. Dr. Conway, who also leads the state and certification group at CMS, acknowledged the problem and indicated he will assist AGA with this issue.
Dr. Kevin Larsen, medical director of meaningful use at ONC, discussed ONC’s efforts to balance the need for more specialized EHR systems while keeping costs down. He also talked about the need to ensure that EHR data is clinically important and useable, while being implemented in the least burdensome manner. He noted that interoperability is a key aspect of ONC’s work and discussed efforts to develop data transmission standards and common clinical and demographic definitions that can be used across EHRs. AGA strongly believes that without interoperability and useability standards, physicians will not be able to achieve the quality goals as defined by CMS.
On a related note, House Republican leaders of the Ways and Means and Energy and Commerce Committees wrote a letter to CMS urging them to suspend EHR meaningful use incentive payments and strengthen meaningful use criteria. Republican leaders believe that physicians are being awarded bonuses without having to demonstrate much in return. The Republicans argue that providers are still operating in silos since systems can’t talk to each other and are not closer to interoperability than when meaningful use began.
AGA plans to maintain an ongoing dialogue with leaders on Capitol Hill and with the agencies that oversee the quality and value-based purchasing programs. We will continue to monitor progress of these critical programs and provide our members with the knowledge, tools and resources necessary to thrive in this new health care landscape. Look for more updates in AGA eDigest and on the AGA Washington Insider, a policy blog for GIs.