The AAMC March 14 sent an introductory letter to newly confirmed Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, which highlights academic medicine’s role in clinical care, training, and research, and outlines the association’s key regulatory positions and concerns surrounding inpatient, outpatient, post-acute care, and advanced payment model payment and quality related issues. Administrator Verma previously worked for Vice President Mike Pence to reshape Indiana’s Medicaid program when he was the state’s governor.
The letter highlights a number of quality measurement related priorities, including a request that CMS include language in the fiscal year (FY) 2018 inpatient prospective payment system (IPPS) proposed rule that would incorporate a sociodemographic status (SDS) adjustment to hospital penalties under the Hospital Readmissions Reduction Program. These changes are mandated by the 21st Century Cures Act (P.L. 114-255). The AAMC also requests that CMS remove burdensome and flawed quality metrics from the hospital reporting and performance programs, including the patient safety composite (PSI-90).
The AAMC also requests that CMS work with Congress to eliminate or modify the requirement that a patient spends three days as a hospital inpatient before being eligible for skilled nursing facility (SNF) services. In the letter, the association recommends that the agency create waivers of these requirements for alternative payment models and move to “eliminate policies that may impede good care and have the potential for imposing financial penalties on providers and patients alike.”
Finally, the AAMC asks CMS to slow down the pace of future regulatory changes which “exceeds both hospitals’ adaptive capacity and the agency’s ability to accurately model and sufficiently explain the impact of either past or current proposals.” The association recommends that CMS review ongoing regulatory activities to understand better the impact of these changes on providers.