CMS has come up with practical solutions for the healthcare industry; it has constantly fought against the burnout epidemic by reducing reporting requirements. We, as a MIPS Qualified Registry, appreciate their efforts and of their administrator, Ms. Seema Verma.
In the recent CMS Quality Conference 2020, the captain spoke herself and mentioned the achievements of the agency and what lied ahead. Starting with the accountability of her team across the board, she said she has identified the set of objectives. She further stressed on quantifying and measuring progress as they gradually realize the 16 strategic initiatives.
The Three Objectives
CMS has a mission and a goal to achieve. Irrespective of the obstacles ahead, according to administrator Verma, CMS is going to be relentless in their approach to accomplish the following objectives:
- Improve the quality and bringing healthcare within the means of all Americans;
- Drive healthcare towards a value-based system from a volume-based system;
- And, don’t let the bubble of American healthcare spending go bigger.
Quality is the top objective CMS is looking to nail. Without good quality, Ms. Verma indicated, efforts to lower cost and improve healthcare availability are fruitless. What good is a health plan, when the care you get is below par?
The Unique Role of the Government
Similar to the rules for the airline industry or the food sector, the government must set for the healthcare industry. Not only do they ensure a high standard of care, but these guidelines will protect the patients’ rights from the very beginning.
The consumers have to know and have to be sure that the hospitals are safe for them; nursing homes are places where their loved ones are taken care of; laboratory tests are accurate, and dignity is alive in hospice care.
CMS has an overall responsibility to oversee quality not because they are the nation’s largest insurer, but because people look up to them for setting the safety and quality standards for every facility that receives Medicare reimbursement. They believe that the government has a unique role to play to create and preserve an unbiased rulebook for a healthy competition.
In that sort of environment, patients are protected and providers compete against each other to provide the highest quality of care. Soon after MIPS 2019 reporting, we have MIPS 2020 to look up to, so that high-quality care prevails across the country.
The physician compare or hospital care portals populate for the sake of patients to make informed decisions. Choose the right clinician with reviews and performances in the Quality Payment Program (QPP).
Trump Administration’s Take on Quality
Trump administration has a keen interest in healthcare, and over the past three years, it has come up with several Presidential executive orders to ensure quality and price transparency, Advancing American Kidney Health, and redefining Medicare.
To realize Trump’s vision, CMS is the enforcing body to implement these orders for better quality outcomes. Since the elections are near, Trump administration’s stance on quality of care in hospitals, facilities, and practices are going to be key in his win in the relevant constituencies. Whether Bernie Sanders or Joe Biden, in my opinion, whoever takes a bold initiative on healthcare will make the underlying difference.
CMS’ New Quality Strategy
In this recently held conference, Ms. Seema Verma unveiled the new quality strategy that will implement the Trump administration’s vision in letter and spirit. It was a proud moment for her and the agency that dedicates most of its time to healthcare management, improve patient experience, and focuses on patient engagement for distinct results.
Last year, the framework that was initiated for the safety and quality of nursing homes was incredibly successful. As a result, CMS has announced to apply the same framework in other areas with room for improvement. The MIPS in healthcare is a step in that direction in which we can have a close to a perfect system.
The Four Pillars of the New Quality Strategy
- CMS will establish government standards for quality care along with measures such as the MIPS Quality measures.
- Improve the knowhow of the system and enforce quality protocols for accountability.
- Share quality information with the public to promote transparency and competition. More so, empowering patients with grand patient experience.
- Modernize quality activation efforts by the use of technology and data analytics.
MIPS Value Pathways in 2021 will Navigate the Quality Measures
One of the ways the new quality strategy will see the face of implementation is in the form of Merit-based Incentive Payment System Value Pathways in 2021, according to Medscape. Instead of using the six quality measures, MIPS Value Pathways will allow physicians to choose measure sets most relevant to their specialty or patient population.