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New CMS Rule Enables Better Collaboration Between Hospitals & Ambulatory Care Providers

On Monday, March 9, the Centers for Medicare & Medicaid Services (CMS) released the Interoperability and Patient Access final rule that implements interoperability and patient access provisions of the 21st Century Cures Act. This rule establishes a new Condition of Participation (CoP) for all Medicare, Medicaid, and CHIP participating hospitals.

What is the Rule?

The CMS Interoperability and Patient Access Rule is intended to move healthcare towards interoperability—a vision that Collective wholeheartedly embraces. It highlights a renewed commitment to the vision set out in the 21st Century Cures Act of improving access to and quality of information that Americans need to make informed decisions about their health. This includes information on healthcare prices and outcomes, while making every effort to minimize reporting and administrative burdens on providers and payers.

Within the final rule, CMS is modifying Conditions of Participation (CoPs) to require hospitals—including psychiatric and critical access hospitals—to send electronic patient event notifications to a patient’s primary care provider, primary care practice group, other practitioners identified by the patient as responsible for his or her care, or applicable post acute providers caring for the patient whenever a patient is admitted, discharged, or transferred.

How Does This Impact Hospitals?

The new CoPs will become effective 12 months after the final rule is published in the Federal Register, at which time hospitals will need to set up necessary infrastructure and processes or partner with an intermediary that can satisfy the requirements.

Hospitals must send notifications to those recipients that “need to receive notification of the patient’s status for treatment, care coordination, or quality improvement purposes.” All of a patient’s necessary medical information—including post-discharge goals of care and treatment preferences—must be documented in the patient’s medical record and transferred at the time of discharge to appropriate healthcare providers and practitioners responsible for the patient’s follow-up or ancillary care. There is no specified standard for the content, format, or delivery of event notifications.

How Can Collective Help?

At Collective Medical, we believe that effective, real-time collaboration is key to providing high-quality care. With the leading ADT-based network for care coordination, Collective facilitates and enables seamless data sharing allowing healthcare providers, facilities, and practitioners to make informed decisions at the point of care.

For the past decade, Collective has been supporting thousands of providers at the point of care with actionable insights—resulting in reduced provider burden, improved patient care, and lower costs. Our national network is the largest of its kind. We want to support hospitals as they seek to comply with the new rule, but more importantly, we believe that the new rules from CMS provide a unique opportunity for hospitals to make meaningful use of ADT data to improve care, especially for vulnerable populations.  

As an intermediary, Collective’s solution can ensure compliance with the CoP requirement. Learn how Collective can help your hospital meet these requirements.

Vatsala Pathy
VP, Regulatory and Government Affairs