'Busy Year' for CMS Means Major Changes for Physicians, Practices

The continuing shift toward value-based payment, the transition to ICD-10, and the push toward the Stage 2 rules of the government's EHR Incentive Program are just a few of key areas CMS is focusing on in 2014. 

That's according to CMS Administrator Marilyn Tavenner, a keynote speaker at this year's Healthcare Information and

Management Systems Society (HIMSS) Conference in Orlando, Fla.

Over the past few years, the agency, and healthcare as a whole, have made great strides, Tavenner told attendees, pointing to increasing patient access to insurance; slowing the rate of healthcare spending; and fostering new payment models that reward high-quality, low-cost care.

"CMS has created quality reporting programs in almost all care settings," said Tavenner. " ... The next step, which many of you have already seen because it exists, is value-based purchasing. Here is the next link of not only payment to quality, but payment to performance on cost reduction and patient health outcomes."

Tavenner acknowledged that 2014 will be a "busy year" for CMS, and she pointed to four major initiatives that are coming down the pipeline.

1. The Open Payments program. This system, part of the Physician Payments Sunshine Act, is designed to create a usable public file that discloses the financial interest or arrangements between physicians and suppliers, said Tavenner. The agency is still in the early stages of creating this system; however, it is forecasted to be operational this fall. "It is ongoing and it is on the 2014 timeline," she said.

2. ICD-10. Tavenner emphasized that there will be no more delays to the transition to ICD-10 on Oct. 1, 2014. "Let's face it guys," she said. "We've delayed this more than once and it's time to move on." As of last October, all fee-for-service systems at CMS were ready for the transition, she said, noting that much of the agency's current focus is on testing. That testing includes internal testing for the claims processing systems, beta testing, testing tools for the provider community, and end-to-end testing. 

3.  Continued work on the health insurance exchanges. Despite the challenges related to the launch of Healthcare.gov, Tavenner said she is pleased to report "substantial" progress. Throughout 2014, she said, the agency will continue to make changes and improvements to the site. "This work has certainly changed the look, the feel, but most importantly the ability to obtain health insurance for many in the United States. It really has been a historical point in time." 

4. Meaningful use. Tavenner said she expects all eligible providers to meet the requirements for the second stage of meaningful use in 2015, and she urges them to do all they can to meet the requirements this year. "I know that there have been many concerns and believe me, we have listened to those concerns and we are sensitive to those concerns," she said. "We have tried to make changes in the schedule - the delay of Stage 1, pushing back Stage 2 as far as we could, pushing back Stage 3 - but now is not the time for us to start moving forward."