Impact of New Physician Fee Ruling On Health IT

Devin Partida

By Devin Partida, technology writer and the editor-in-chief,

On Dec. 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released its final ruling on policy and payment changes to the Medicare Physician Fee Schedule (PFS) for 2021. Beginning on Jan. 1, 2021, the final adjustments from CMS went into effect.

Primarily, the changes focus on expanding the services that telehealth covers and making them more permanent. In addition, CMS lowered the conversion factor for 2021. However, through expanding remote services and changing limitations on payments, it’s now critical to see how Health IT will need to adjust.

IT departments have a unique set of responsibilities throughout the pandemic. As more services become available through telehealth, the organization must focus on securing those interactions and all the patient and business data that comes with them.

The Changes From CMS

The changes from the CMS ruling ultimately affect how health IT operates. New dynamics entail increased health IT services.

Topping the list of changes, the ruling cites a decrease in conversion to $32.41, down from $36.09. After reducing the conversion rate, CMS then estimates Medicare spending will increase by $10.2 billion in 2021. This change makes room for the industry to add more services in the telehealth sector, which has been invaluable for staying safe during the COVID-19 pandemic.

Accordingly, the ruling expanded what qualifies as a telehealth service that Medicare will cover. Clinical social workers, psychologists, physical therapists, speed-language pathologists, and occupational therapists are all among the newest additions. They can now bill patients for telehealth services.

For the United States, the pandemic arrived in full swing in March 2020. While health care organizations adjusted throughout the year, these new CMS changes are solidifying what they started. Making these services permanent means all patients will have access to remote care after COVID-19 ends.

Some more subtle changes also expanded the qualifications for remote patient care. For instance, Medicare can now cover patients with chronic and acute conditions who use telehealth services. Health care providers can also provide assessment and evaluation services online for patients.

The Impact on Health IT

Among a long list of changes, the expansion of permanent remote care services stands out the most for Health IT. All health care organizations must provide the top security and protection for themselves and their patients during telehealth practices. Now that CMS is making permanent many of these remote services, health IT must adjust.

The past year has been a tumultuous one, especially for health care. Experts point to telehealth services as one of the most vulnerable areas within the industry, primarily because cybercriminals can prey on these new technologies and all the private, personal data that comes with them. The permanent CMS 2021 changes signify that the industry could now see prolonged criminal activity, without the right proactive steps, that is.

Fortunately, the CMS ruling points health care in the right security-driven direction. As the official announcement states, after the public health emergency officially ends, health care organizations will need to collect and report 16 days of data every 30 days. This kind of monitoring will help ensure the transitional period goes smoothly, with no cybercriminal activity.

Still, despite the benefits of this new ruling, there are some areas that require improvements. For instance, the Association of American Medical Colleges acknowledges the benefits of expanding remote services but raised concerns about the new budget adjustments coming when COVID-19 is still the primary health concern in the States.

If CMS wants to ensure it expands telehealth effectively, it must consider putting funding into health IT. That way, all health care organizations have the best resources and support systems to work with patients from a distance while protecting data.

The Future of the Medical Landscape

Technology has been a critical factor for health care for years. However, with the pandemic came a heavy reliance on telehealth. Through the PFS 2021 changes, this new digital landscape appears to be here to stay.

While this brings many benefits for accessibility, moving forward, the main obstacles will be in health IT. Protecting information and providing stellar service are now the two pillars of the industry.

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