Written by Shawn Hewitt
The American Medical Rehabilitation Providers Association (AMRPA) serves as rehab providers’ beacon for advocacy and is committed to the interests of rehab providers across the continuum of care. Last month, I had the pleasure of attending the AMRPA Spring Conference and Congressional Fly-In in Washington, D.C. that featured industry leaders, advocates, and policymakers discussing the current federal regulatory climate and how policy continues to shape the future of the rehab industry.
As a proud sponsor and member of AMRPA, Mediware’s support furthers both organizations’ shared mission of helping rehab providers meet industry challenges and compliance requirements in today’s ever-changing regulatory landscape.
Here are three key regulatory takeaways from AMRPA’s spring conference that all rehab providers need to know about now:
1. Ongoing Legislative and Regulatory Change
Legislation and regulations continue to focus on reducing the cost of health care. Policy is increasingly focused on outcomes to substantiate quality care and drive improvement of population health management. Rehab providers need to develop programs to increase quality and value while also decreasing the cost of delivering care. The Trump Administration remains set on repealing or changing the Affordable Care Act (ACA, or Obamacare). Rehab providers need to monitor changes, continuations, and new additions to programs and policies affecting the rehab industry. All rehab providers need to understand the impact of:
- The Affordable Care Act (ACA): Providers need to learn how the ACA will continually be impacted by current administration. The current law has three primary goals: 1. Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level. 2. Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level (not all states have expanded their Medicaid programs). 3. Support innovative medical care delivery methods designed to lower the costs of health care generally.
- Accountable Care Organizations (ACOs), and the focus on improving coordinated care.
- The Bundled Payments for Care Improvement (BPCI) initiative: “Bundled Payments for Care Improvement initiative” is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.
- Alternative payment models (APMs) and advanced APMs that offer payment approaches that add incentives for providing high quality of care via cost-conscious delivery models.
- How managed care plans and Medicare Advantage Plans affect access to care.
- The processes for audits, denials, and appeals.
- The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Merit Based Incentive Payments System (MIPs), and their impact on outpatient care. CMS defines MACRA as a bipartisan legislation signed into law on April 16, 2015. MACRA created the Quality Payment Program, which: repeals the Sustainable Growth Rate formula, changes the way that Medicare rewards clinicians for value over volume, streamlines multiple quality programs under the new MIPs (MIPs for therapy are slated for January 1, 2019), gives bonus payments for participation in eligible alternative payment models (APMs), and MACRA also required us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.
2. Overview of the President’s 2019 Budget
The 2019 budget prioritizes the following key areas:
- Quality in health care
- Workforce growth
- Less procedural challenges and supporting health care providers’ ability to “be in front of patients” rather than completing paperwork
- National security
- Repeal/replace Obamacare
- Changes that result in minimal impact to the Medicare beneficiary and allow proper access to Medicare programs
- Uncompensated care and its impact on the Medicare trust fund. Identifying other ways that uncompensated care can be covered
- The opioid epidemic
- Site-neutral payment policy: The feeling is the way post-acute care is reimbursed does not make sense. There will be continued focus on actual services provided and need versus physical location. This will result in payment consolidation and one unified post-acute care prospective payment system.
- Improvement in program integrity and better data analytics
3. More Patient Care, Less Paperwork
Regulatory trends are still focused on increasing patients’ engagement and involvement in their own care. Conference speakers referenced several programs designed to help patients obtain immediate access to their health records. CMS will be dedicated to initiatives intended to eliminate or decrease the time-consuming tasks of repetitive data collection and documentation management.
The “Patients Over Paperwork” initiative was consistently referenced throughout the conference. It was refreshing to hear discussion on more focused efforts to reduce paperwork and prioritize care. Seema Verma, administrator of CMS, announced programs like “MyHealthEData,” which promises to give patients better control of their health records. MyHealthEData’s goal is to empower patients to request and obtain an electronic copy of their entire health record and share data with providers. CMS also highlighted a program called “Blue Button 2.0,” which gives Medicare beneficiaries ability to share their health data in universal digital format. More than 100 organizations have signed up to use Blue Button 2.0 to develop secure applications for patients to access, print, and share their personal health information.
AMRPA’s spring conference continues to be an excellent opportunity to learn about the advocacy happening to protect the rehab services and programs our industry offers. If you’re not a current AMRPA member, there are plenty of benefits of becoming a member, including information about the latest regulatory trends and insights like this. As health care continues to change, it behooves rehab providers to embrace educational opportunities and software solutions that help balance compliance with efficiency and deliver quality care to patients.