News you can use: September 14, 2017

As part of our mission to transform healthcare, we want to keep you informed of regular industry updates. News You Can Use provides a brief overview of relevant healthcare topics.

In this issue, we cover an emergency spending bill for Veterans, HRRP penalties, the release of a revised Medicaid toolkit, and comments from Cognosante on a recent CMS proposal.

1) Bill funds Veterans Choice Program

President Trump recently signed a bill that will provide an additional $2.1 billion for the Veterans Choice Program (VCP). The program allows Veterans who have excessive wait times (30 days or more) or who have to drive long distances (40 miles or more) to reach VA facilities to seek private care for their medical needs. The VCP was created as a temporary program after it was discovered in 2014 that Veterans were facing extremely long wait times for medical appointments.

2) HRRP readmission penalties climb

The Hospital Readmissions Reduction Program (HRRP), mandated by the Affordable Care Act (ACA), is levying more penalties against hospitals. The purpose of the program, from the Centers for Medicare & Medicaid Services (CMS), is to curb health costs by reducing readmissions. The effort initially showed positive results, but progress has stalled, and Medicare is penalizing hospitals in record amounts.

3) CMS releases new version of MEET toolkit

The CMS released a new version of the Medicaid Eligibility and Enrollment Toolkit (MEET). The purpose of the toolkit is to help states streamline and modernize their Eligibility and Enrollment (E&E) systems.

The Medicaid Eligibility and Enrollment Life Cycle (MEELC) is a major component of the new toolkit. The toolkit describes important MEELC roles, provides tools for states to use, and offers an end-to-end view of the CMS process for reviewing the Medicaid E&E business functions and supporting state systems.

4) Cognosante offers comments on CMS proposal

Cognosante recently offered comments on the 2018 CMS Quality Payment Program proposal. The goal of the program is to “improve health outcomes, spend wisely, minimize the burden of participation, and be fair and transparent.”

Cognosante recommended that Health Information Exchanges (HIE) be considered health IT vendors on the list of third-party intermediaries that can submit data—from the quality, clinical practice improvement, and advancing care information performance categories—to the CMS on behalf of clinicians eligible for the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program rule for the 2017 calendar year.