THE ARISING · Markets & Strategy
CMS Proposes Administrative Cuts Across Healthcare, Estimating $320 Million in Savings
CMS estimates its proposed CARE rule could save $320 million and more than 3.26 million staff hours across the healthcare continuum. The changes have not been finalized.
The Centers for Medicare and Medicaid Services (CMS) issued the proposed rule on Thursday. It is titled Cutting Administrative Requirements for Excellence in Patient Care, or CARE. According to a CMS fact sheet, it follows a review of regulations covering 21 provider and supplier types. The savings estimate covers the health care continuum, not nursing homes alone.
For skilled nursing operators, the most direct changes touch reporting. CMS proposes to eliminate three Medicaid payment transparency requirements for nursing facilities and intermediate care facilities for individuals with intellectual disabilities. They cover the share of Medicaid payments going to direct care worker compensation and support staff compensation in nursing facilities, and to support staff compensation in the intermediate care facilities. CMS says this would reduce burdens for states and providers.
The rule would also trim COVID-era requirements. CMS proposes to streamline remaining COVID-19 vaccination requirements for residents so they match those for other respiratory viruses. It would cut requirements for nursing homes and intermediate care facilities to educate staff about COVID-19 vaccine benefits and risks, offer the vaccines and document those actions. Separately, CMS is seeking comments on allowing residents to opt out of discharge notices being sent to state ombudsman offices.
The workforce signals may matter as much as the savings. CMS is seeking input on expanding the scope of practice for physician assistants and nurse practitioners in long-term care facilities, including letting them perform visits now required to be done by physicians. It also seeks comment on future policies to address Medicaid institutional workforce shortages.
Next, watch the public comment period and which of the transparency and scope-of-practice items survive into a final rule.