(Sept. 25, 2020) – MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following:
CMS Expands Ambulance Program Integrity Payment Model
The Centers for Medicare & Medicaid Services announced that it is expanding the Medicare Prior Authorization Model for Repetitive, Scheduled Non-emergent Ambulance Transport nationwide. The RSNAT Prior Authorization Model "tests whether prior authorization — or advanced approval of a service before the service is furnished and before a claim is submitted for payment — helps save Medicare money while maintaining or improving the quality of care for repetitive, scheduled nonemergency ambulance transportation." The model already has saved Medicare about $650 million throughout a four-year period.
NRHC Publishes Report on Rural Post-Acute Care
The National Rural Health Resource Center, in collaboration with key stakeholders, published a report that provides background on the importance of post-acute care, including a comprehensive list of identified strategies and tactics to address high priority rural post-acute care issues. The report explores issues, challenges and strategies related to the integration of rural acute and post-acute care, and considered how it can successfully be included in a population health and value-payment future.
TJC Offers Webinar on Performance Measurement Reporting Requirements
The Joint Commission is hosting a Pioneers in Quality webinar at 11 a.m. Tuesday, Oct. 20. The discussion will review 2021 ORYX performance measurement requirements for chart-abstracted and electronic clinical quality measure data submission for accredited and critical access hospitals. Registration is required.
CMS Announces ESRD and Radiation Oncology Innovation Payment Models
The Centers for Medicare & Medicaid Services announced two innovation models, the End Stage Renal Disease Treatment Choices Model and the Radiation Oncology Model. Both are included in a recently published final rule on Medicare specialty care models to improve quality of care and reduce expenditures.
The ETC Model will test whether greater use of home dialysis and kidney transplantation for Medicare beneficiaries with ESRD will reduce Medicare expenditures while enhancing the quality of care. The ETC Model would adjust certain payments to nephrologists and other clinicians treating beneficiaries with ESRD. CMS is estimating the savings to be $23 million over five and a half years.
The RO Model will allow greater focus on value-based care by creating a simpler, more predictable payment that incentivized cost-effective and clinically effective treatments to improve quality and outcomes. CMS is estimating that the model will save Medicare $230 million over five years.
CMS Announces Availability of eCQM 2020 Change Review Process
Now available is the 2020 Change Review Process for electronic clinical quality measures. The CRP provides eCQM users the opportunity to review and comment on draft changes to the eCQM specifications and supporting resources under consideration by the measure steward. The goal of the CRP is for eCQM implementers to comment on the potential impact of draft changes to eCQMs so the Centers for Medicare & Medicaid Services and measure stewards can make improvements to meet the CMS intent of minimizing provider and vendor burden in the collection, capture, calculation and reporting of eCQMs.
This latest installment of the CRP for eligible professional/eligible clinician and eligible hospital/Critical Access Hospital issues will be conducted using the web-based public comment tools on the ONC Project Tracking System eCQM Issue Tracker during fall 2020. Note that an ONC Project Tracking System account is required to post a question or comment. New users can create an account via the ONC Project Tracking System website.
CRP updates regarding issues available for public comment will be posted on the ONC Project Tracking System eCQM Issue Tracker summary page. To subscribe to weekly CRP digest emails containing updates on CRP activities, email CRP@mathematica-mpr.com.
TJC Posts Specifications Manual Version 2020B3
The specifications manual for The Joint Commission National Quality Measures, version 2020B3, and associated release notes have been posted to the TJC website. This version contains updates to Appendix A (ICD 10 updates) effective Oct. 1 to Dec. 31, 2020. Changes made to the manual are outlined in the release notes.
HHS Awards $25 Million to Combat Rural Opioid Crisis
The U.S. Department of Health and Human Services announced 80 organizations in 36 states and two territories who will receive nearly $25 million in grant funding through the Health Resources and Services Administration as part of the Rural Communities Opioid Response Program. HHS reported nearly $15 million will to go 30 recipients to reduce neonatal abstinence syndrome by improving care, family supports and factors related to social determinants of health. Each recipient will receive $500,000 over three years through the Federal Office of Rural Health Policy. Additionally, $10 million will go to 50 recipients to strengthen and expand substance use and opioid use disorder prevention, treatment and recovery services, funded through Rural Communities Opioid Response Program Planning.
NCHS Finds Heavy Drinking Among U.S. Adults
Data from the National Health Interview Survey in 2018 was released from the National Center for Health Statistics finding that in 2018, two-thirds, or 66.3 percent, of adults aged 18 and over consumed alcohol in the past year. Among adults aged 18 and over, 5.1 percent engaged in heavy drinking. Additional key findings found adults who regularly felt worried, nervous or anxious, or who regularly felt depressed, were more likely than adults without these feelings to engage in heavy drinking in the past year.
Heavy drinking is associated with an increased risk of alcohol use disorders, suicide, interpersonal violence, traffic injuries, liver disease, certain cancers and infectious diseases, and adverse birth outcomes in pregnant women. The U.S. Preventive Service Task Force recommends screening adults for unhealthy alcohol use in primary care settings and providing brief behavioral counseling to those whose drinking exceeds certain weekly, daily or per-occasion amounts.
HRSA Announces National Research Service Award Funding Opportunity
The Health Resources and Services Administration is accepting applications for the fiscal year 2020 National Research Service Award program. The application cycle closes on Monday, Nov. 9.
This funding opportunity will allow eligible institutions to train and provide support to postdoctoral health care professionals who are planning to pursue careers in biomedical and behavioral health research related to primary care. Grantees will train researchers to study issues facing the primary care workforce across the nation.