CMS Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes
Today, the Centers for Medicare & Medicaid Services (CMS) is announcing the creation of the Office of Burden Reduction and Health Informatics to unify the agency’s efforts to reduce regulatory and administrative burden and to further the goal of putting patients first. The new office is an outgrowth of the agency’s Patients over Paperwork (PoP) Initiative, which is the cornerstone of CMS’s ongoing efforts to implement President Trump’s 2017 executive order to “Cut the Red Tape” and eliminate duplicative, unnecessary, and excessively costly requirements and regulations. This announcement permanently embeds a culture of burden reduction across all platforms of CMS agency operations.
CMS’s burden reduction work began three years ago with the launch of our PoP Initiative, which has focused on reducing unnecessary regulatory burden, in order to allow providers to concentrate on their primary mission: patient care. The results are expected to save providers and clinicians $6.6 billion and 42 million unnecessary burden hours through 2021. As part of our efforts to date, CMS has heard from over 2,500 providers, clinicians, administrative staff, health care leaders, beneficiaries and their support teams through 158 site visits and listening sessions. Through more than 10 Requests for Information (RFI) combined with stakeholder interviews, CMS also has over 15,000 comments to assist us in our burden reduction efforts.
These efforts have yielded significant results:
- Removed unnecessary, obsolete, or excessively burdensome conditions of participation for hospitals and other healthcare providers saving an estimated 4.4 million hours of time previously spent on paperwork with an overall total projected savings to providers of $800 million annually.
- Removed 235 data elements from 33 items on the Outcomes and Assessment Information Set (OASIS) assessment instrument for home health.
- Established within the Quality Payment Program (QPP), a consolidated data submission experience for the different performance categories of the Merit-based Incentive Payment System (MIPS) so that clinicians no longer need to submit data in multiple systems.
- Eliminated 79 measures, through modernizing proposals to advance our Meaningful Measures Initiative, resulting in projected savings of $128 million and an anticipated reduction of 3.3 million burden hours through 2020.
- Implemented changes resulting in faster processing of state requests to make program or benefit changes to their respective Medicaid programs through the state plan amendment (SPA) and section 1915 waiver review process.
“The Office of Burden Reduction and Health Informatics will ensure the agency’s commitment to reduce administrative costs and enact meaningful and lasting change in our nation’s health care system,” said CMS Administrator Seema Verma. “Specifically, the work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics, and improve the beneficiary experience.”
Today’s announcement continues CMS’s burden reduction efforts from both before and during the COVID-19 pandemic. When President Trump declared a national coronavirus emergency on March 13, 2020, CMS took action nationwide to aggressively respond to COVID-19. In March, CMS announced unprecedented relief for the clinicians, providers, and facilities participating in Medicare quality reporting programs, including the 1.2 million clinicians in the Quality Payment Program who are on the front lines of America’s fight against COVID-19, by granting them exceptions to reporting requirements and extensions for reporting measures and data.
Under these extreme and uncontrollable circumstances, CMS also implemented additional exceptions for upcoming measure reporting and data submission deadlines for a number of programs, including provider, hospital, and post-acute programs, during the COVID-19 emergency. Additionally, during the pandemic CMS has taken actions to ease federal rules and to institute new flexibilities to ensure that states and localities can focus on patient care and can ensure that care is not delayed due to administrative red tape. CMS is committed to leveraging the significant flexibilities introduced in response to the COVID-19 pandemic as we continue to lead the rapid transformation to value-based healthcare.
The new office will strengthen CMS’s efforts across Medicare, Medicaid, the Children’s Health Insurance Program and the Health Insurance Marketplace to decrease the hours and costs clinicians and providers incur for CMS-mandated compliance. It will take a proactive approach to reducing burden, carefully considering the impact of new regulations on health care system operations. The new office will also increase the number of clinicians, providers, and health plans the Agency engages, to ensure that CMS has a better understanding of how various regulatory burdens impact healthcare delivery. Stakeholder feedback is critical to addressing provider and clinician burden, as it helps CMS to remove or modify outdated regulations that impede innovation, ultimately resulting in improvements in healthcare delivery.
Additionally, the Office of Burden Reduction and Health Informatics will focus on the important work of health informatics, which uses and applies health data and clinical information to provide better healthcare to patients. Fostering innovation through interoperability will be an important priority, and the office will leverage technology and automation to create new tools that allow patients to own and carry their personal health data with them seamlessly, privately, and securely throughout the health care system. By providing clinicians with a complete medical history, they can deliver better coordinated, higher quality care. Coupled with implementation and enforcement of adopted national standards, this office will also work with the broader healthcare community to continue to make key administrative processes increasingly more efficient.
With the formation of the Office of Burden Reduction and Health Informatics, CMS will continue to draw on the specialized expertise of staff, and frequent stakeholder input, to continue to explore innovative ways to address regulatory reform and burden reduction. All of these efforts will help ensure that providers and clinicians can focus their efforts on what is most important: keeping patients healthy, improving health outcomes, and enhancing patient satisfaction.