The second day of the 2018 Centers for Medicare & Medicaid Services (CMS) Quality Conference began with leaders reinforcing the agency’s commitment to reducing burdens on providers and bringing person and family engagement (PFE) into the heart of care decisions.
Kate Goodrich, MD — CMS chief medical officer and director of the Center for Clinical Standards and Quality (CCSQ) — kicked off the February 13 morning plenary by highlighting CMS’s efforts to help reduce unnecessary administrative paperwork for physicians, which detracts from their ability to care for patients.
Goodrich specifically mentioned Patients Over Paperwork, and Meaningful Measures as key drivers of innovation and change at the agency. She explained that while many conference attendees live and breathe these human-centered initiatives every day, the broader care community may not understand the concepts and how they fit together.
“Patients Over Paperwork is designed to reduce burden on providers in service of better safety, outcomes and program integrity,” she said.
Goodrich went on to share several steps that CMS has taken to address burden reduction by “listening to our customers,” including clinicians, billing department staff, skilled nursing professionals, patients and other stakeholders. Among those steps are using journey mapping — evidence-based tools around human-centered design to help understand the customer holistically.
Further, Goodrich said that CMS has identified and begun tackling some “low-hanging fruit.” For example, CMS now allows facilities to submit plans of correction in Microsoft Word format and no longer requires attending physicians to document what medical students themselves document when working together with a patient.
Goodrich also described how CMS is going about implementing Meaningful Measures to ensure better patient outcomes and reduced provider burden. Besides reviewing existing measures to see if they work, lead to better outcomes and are worthwhile for patients and providers, the agency is developing new measures to fill critical gaps (e.g., opioid use reduction), streamlining the data collection process and eliminating unnecessary measures. Already, the agency has developed an application programming interface for CMS’s Quality Payment Program to facilitate data submission.
Amplifying the importance of placing patient needs at the center of care, Jean Moody-Williams — deputy director of CCSQ — moderated a patient panel featuring Sterling Health IT Consulting chief executive officer MaryAnne Sterling; senior program officer at the John A. Hartford Foundation Amy Berman; and rural health provider Roger D. Wells, MD of Howard County Medical Center (Nebraska).
"We need a health care and social services infrastructure that is easy to navigate, that is flexible, that is affordable, and relentless in its person-centeredness."
Sterling shared the story of her mother who — after battling breast cancer and having several major falls — was unable to receive hospice care in the final days of her life.
Speaking on behalf of family caregivers, Sterling said, "We need a health care and social services infrastructure that is easy to navigate, that is flexible, that is affordable, and relentless in its person-centeredness. And family caregivers have the knowledge and experience to help design it.”
Berman, a seven-year survivor of stage four cancer, talked about the “4Ms” designed to help hospitals, home health care agencies, nursing homes and primary care practices provide person-centered care and avoid harms: what Matters, Medication, Mentation and Mobility.
Wells wrapped up the session by informing attendees how he used to spend 54 percent of his time as a clinician in front of a computer screen dealing with administrative burdens rather than patients. He said that CMS’s efforts to reduce providers’ administrative work have improved his patient outcomes, as well as made being a doctor in a small town of approximately 2,000 people “the most profound and enjoyable practice” of his career.