On January 31, 2025, President Trump issued Executive Order 14192 “Unleashing Prosperity Through Deregulation.” It states that it is the Administration’s policy to reduce how much it costs to comply with Federal regulations, and “to secure America’s economic prosperity and national security and the highest possible quality of life for each citizen.” CMS is seeking public input on approaches and opportunities to streamline regulations and reduce administrative burdens on providers, suppliers, patients, and others. The RFI is available at: https://www.cms.gov/medicare-regulatory-relief-rfi, and comments are due on June 10, 2025.
This is a big deal for providers and EMRs. Data and quality reporting, and the data entry necessary to support its creation, has overwhelmed physicians’ workflows and product roadmaps. CMS is specifically asking the following:
- Which specific Medicare administrative processes or quality and data reporting requirements create the most significant burdens for providers?
- Are there specific Medicare administrative processes, quality, or data reporting requirements, that could be automated or simplified to reduce the administrative burden on facilities and providers?
- What changes can be made to simplify Medicare reporting and documentation requirements without affecting program integrity?
- Are there opportunities to reduce the frequency or complexity of reporting for Medicare providers?
- How can Medicare better align its requirements with best practices and industry standards without imposing additional regulatory requirements, particularly in areas such as telemedicine, transparency, digital health, and integrated care systems?
There’s more, but this is a great starting list of questions. I have a couple of thoughts, too.
First, I am going to venture a guess and say that most clinicians would only like to be measured against clinical quality measures that have statistically significant affect on patient outcomes, as measured in a proper double-blinded study. I am going to also guess that most EMR developers would love to support that number of measures. The only one I am aware of is the hospital re-admission measure, but it’s certainly not hundreds. Each of those things is a tiny word problem where sometimes “one year” means 365 days, sometimes it does not. The whole quality measure reporting system is byzantine because of the intersection of ONC/ASTP certification, the quality data model, the fee schedules, payer-specific measures, etc.
Next, I would also venture to say that most providers find the meaningful use program (whether in MIPS or on the hospital side) to be at best a distraction, and at worst a disaster. The timelines between measure proposal, testing, developer implementation, and user adoption makes physicians hate the workflows that the program measures, and crowds out innovative developers because so much of the product’s roadmap is captured to support tweaks to these reporting programs.
If I were to sum it up, I would say what both groups could use is fewer measures that have never been field tested for any sort of real efficacy. There’s real reporting burn out, and a lot of it stems from a hopeless feeling that it the reporting is meaningless and has no real use.
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