Streamlining paperwork, EHR “interoperability,” and cost-saving telecommunications technology is the focus of proposed 2019 Physician Fee Schedule changes with Medicare.
According to CMS:

“The PFS establishes payment for physicians and medical professionals treating Medicare patients. It is updated annually to make changes to payment policies, payment rates and quality-related provisions. Extensive public feedback the agency has received has highlighted a need to streamline documentation requirements for physician services known as Evaluation and Management (E&M) visits, as well as a need to support greater access to care using telecommunications technology. The proposed changes to the PFS would reinforce CMS’ Patients Over Paperwork initiative focused on reducing administrative burden while improving care coordination, health outcomes, and patients’ ability to make decisions about their own care.

Specifically, this proposal would:

• Simplify, streamline and offer flexibility in documentation requirements for E&M office visits — which make up about 20 percent of allowed charges under the PFS and consume much of clinicians’ time.”

Addressing telecommunication, CMS proposes:

• Paying clinicians for virtual check-ins – brief, non-face-to-face appointments via communications technology
• Paying clinicians for evaluation of patient-submitted photos
• Expanding Medicare-covered telehealth services to include prolonged preventive services

Changes to QPP include:

• Removing MIPS process-based quality measures that clinicians have said are low-value or low-priority, in order to focus on meaningful measures that have a greater impact on health outcomes
• Overhauling the MIPS “Promoting Interoperability” performance category to support greater EHR interoperability and patient access to their health information, as well as to align this performance category for clinicians with the proposed new Promoting Interoperability Program for hospitals

Final comments on the proposals are due September 10.