When CMS unveiled its 2019 Inpatient Prospective Payment System (IPPS) several months ago, it ushered in a new era that emphasizes the exchange of health information between providers and patients. It also incentivizes providers to make it easier for patients to obtain their medical records electronically.

With its focus on reducing administrative burden and increasing time providing care to patients, CMS recently proposed new paperwork flexibility along with new proposals for virtual care reimbursement.

Reducing the Paperwork Burden

The changes to paperwork would push clinicians to increase their use of electronic health record (EHR) documentation by including “clinically meaningful information,” instead of information only for billing purposes.

CMS says the new proposals may allow doctors to spend more time with their patients — what the agency deems a “put patients over paperwork” approach.

“Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This administration has listened and is taking action,” said CMS Administrator Seema Verma in a statement.

CMS says these proposed changes would save individual clinicians an estimated 51 hours per year if 40% of their patients are in Medicare.

CMS also said it acknowledges that getting to the doctor can be a challenge for some people. So now CMS is making new recommendations to modernize the Medicare program by leveraging telehealth technologies.

Reimbursement for Virtual Care

For example, the recently proposed rule would expand Medicare-covered telehealth services reimbursement for virtual check-ins and telecommunications technology in the following ways:

• paying clinicians for virtual check-ins, which are brief, remote appointments via video conferencing;

• paying clinicians to evaluate photos sent by patients;

• expanding Medicare-covered telehealth to include preventive services.

The American Hospital Association (AHA) is “pleased to see CMS taking some steps to expand the ability of physicians to serve patients through telehealth and virtual connections,” AHA executive vice president Tom Nickels said in a statement.

Indeed, the National Institutes of Health has previously said “telehealth gives easier access to care and increases patient involvement and self-awareness for self-care and improved outcomes.”1

For example, advances in virtual care can allow nurse case managers to effectively communicate with patients. Studies have shown that virtual check-ins can solve issues for underserved populations, geographically isolated patients, and those with transportation or mobility issues.

In addition, telehealth has been documented for effective outpatient management of cancer patients with new ostomies and for assisting acutely ill patients in the transition from hospital to home.2,3


1. Day K, Millner S, Johnson H. How Nurses Use Telehealth to Support Health Transitions of Older Adults. Stud Health Technol Inform. 2016;231:23-30.

2. Bohnenkamp SK, McDonald P, Lopez AM, Krupinski E, Blackett A. (2004) Traditional versus telenursing outpatient management of patients with cancer with new ostomies. Oncology Nursing Forum 31(5), 1005-1010.

3. Marineau ML. (2007) Telehealth advance practice nursing: the lived experiences of individuals with acute infections transitioning in the home. Nursing Forum 42(4), 196-208.