Nutrition & Dietetics Academy Hails Patient Diet Ruling

Under the new rule issued by the Centers for Medicare and Medicaid Services (CMS) that is scheduled to take effect July 11, qualified registered dietitian nutritionists will be able to order patient diets and hospitals will be able to privilege them to order nutrition-related laboratory tests to monitor and modify diet plans without the supervision or approval of a physician, according to the Academy of Nutrition and Dietetics, which strongly supports the change.

“Registered dietitian nutritionists will now be able to work more independently in hospitals, providing patients with more effective and efficient nutrition care thanks to the final rule on therapeutic diet orders,” says registered dietitian nutritionist and Academy President Dr. Glenna McCollum. “CMS’ new rule will eliminate burdensome and superfluous regulations that are adding to our nation’s health care costs. Allowing registered dietitian nutritionists to independently order therapeutic diets and monitor and manage dietary plans for their hospital patients will save the country hundreds of millions of dollars and also help hospitals provide better multidisciplinary care.”

By streamlining the health care process, practitioners can focus on treating patients with the highest quality of care, McCollum explains. “CMS made this change after reviewing the substantial scientific evidence demonstrating that registered dietitian nutritionists have the expertise and competency to effectively order diets. We are thrilled that the rule is based on evidence and proven outcomes that will save hospitals money.”

The final rule aims to remove unnecessary and excessive hospital procedures, making facilities more efficient and productive, according to CMS.

“In order for patients to receive timely nutritional care, the RD must be viewed as an integral member of the hospital interdisciplinary care team, one who, as the team’s clinical nutrition expert, is responsible for a patient’s nutritional diagnosis and treatment in light of the patient’s medical diagnosis,” the agency noted in announcing the decision.

“Eliminating extra steps in the treatment process will free up resources, allowing all health care providers to care for patients more effectively and efficiently,” McCollum emphasizes.

The current process for ordering therapeutic diets carries a financial and health burden on the health care system, the Academy has argued. Wrong diet orders and delays in nutrition intervention can result in malnutrition, allergic reactions, choking, or aspiration leading to death and other complications along with increased length of stay and higher readmission rates.

CMS estimates the savings from the new rule at $459 million per year.

“The Academy and our members could not agree more with CMS’ conclusion that ’the addition of ordering privileges enhances the ability that RDs already have to provide timely, cost-effective and evidence-based nutrition services as the recognized nutrition experts on a hospital interdisciplinary team,’” McCollum says.

The Academy has been working with CMS for more than four years to minimize procedural inefficiencies in hospitals and create a system that allows practitioners to work at the highest level of their scope of practice which considers training, expertise and competency.

“The Academy plans to continue to work with CMS to eradicate unnecessary barriers in other health care settings, such as long-term care and ambulatory facilities, to ensure people receive the high-quality nutrition care they deserve.” McCollum says.