IRVING, Texas (BUSINESS WIRE), October 06, 2020 - Vizient, Inc. submitted comments to the Centers for Medicare & Medicaid Services (CMS) yesterday on two key Medicare regulatory proposals – the Calendar Year (CY) 2021 Outpatient Prospective Payment System (OPPS) and the CY 2021 Physician Fee Schedule (PFS) and Quality Payment Program (QPP). Between the two rules, CMS is proposing several policy changes that would impact Vizient members and the patients they serve.
In our comments on the CY 2021 PFS and QPP proposed rule, Vizient encouraged CMS to consider adding the full array of services expanded during the public health emergency (PHE) to either a permanent list of allowable telehealth services (Category 1) or a new Category 3 list of services that would be covered temporarily. Vizient also expressed concern regarding the proposed budget-neutral implementation of certain policies related to evaluation & management (E/M) services which lead to a significant reduction to the conversion factor.
In Vizient’s comments on the OPPS proposed rule, we raised serious concerns about CMS’s ongoing reductions in reimbursement for drugs purchased through the 340B Drug Pricing Program, emphasizing the proposed reductions will have a detrimental effect on hospitals’ abilities to maintain critical programs that serve vulnerable populations. Additionally, Vizient urged CMS to similarly withdraw proposals to eliminate the inpatient-only list noting concerns regarding provider burden and patient safety.
While our comments raised significant concerns on a number of issues, Vizient also applauded the agency for efforts to update to the Overall Hospital Quality Star ratings system and offered several recommendations to further improve the system.
“We are pleased to see the agency acting on industry feedback on removing the latent variable model, reducing the number of categories used to determine star ratings, peer grouping hospitals by measures reported and risk stratifying the readmission measures by dual eligibility status grouping,” said David Levine, MD, FACEP, group senior vice president, advanced analytics and product management for Vizient. “These proposed changes to the rating methodology will be more predictable, enabling hospitals to more effectively use the star ratings for quality improvement efforts.”
Vizient hopes that CMS will take its comments into account and continue efforts to ease regulatory burdens, while also improving the final rules in ways that will support hospitals and clinicians in their efforts to provide needed clinical services to their communities. The final rules will be released in November, with many of the policy changes going into effect Jan. 1.
Vizient is the nation’s largest health care performance improvement company serving a diverse membership that includes academic medical centers, pediatric facilities, community hospitals, integrated health care delivery networks and non-acute health care providers.
About Vizient, Inc.
Vizient, Inc. provides solutions and services that improve the delivery of high-value care by aligning cost, quality and market performance for more than 50% of the nation’s acute care providers, which includes 95% of the nation’s academic medical centers, and more than 20% of ambulatory providers. Vizient provides expertise, analytics and advisory services, as well as a contract portfolio that represents more than $100 billion in annual purchasing volume, to improve patient outcomes and lower costs. Vizient has earned a World’s Most Ethical Company designation from the Ethisphere Institute every year since its inception. Headquartered in Irving, Texas, Vizient has offices throughout the United States. Learn more at www.vizientinc.com.