Monday, April 10, 2023 | In The News
CMS Proposes Policies to Improve Patient Safety and Promote Health Equity
Proposed Rule Would Reward Hospitals that Deliver High-Quality Care to Underserved Populations
Today, the Centers for Medicare & Medicaid Services
(CMS) issued a proposed rule for inpatient and long-term care hospitals that
builds on the Biden-Harris Administration's key priorities to advance health
equity and support underserved communities. As required by statute, the fiscal
year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care
hospital prospective payment system (LTCH PPS) rule updates Medicare payments
and policies for hospitals. The rule would also adopt hospital quality measures
to foster safety, equity, and reduce preventable harm in the hospital setting.
CMS is proposing to recognize homelessness as an indicator of increased
resource utilization in the acute inpatient hospital setting, which may result
in higher payments for certain hospital stays. This action aligns with the
Administration's goal of providing support to historically underserved and
under-resourced communities.
"CMS
is helping to build a resilient health care system that promotes good outcomes,
patient safety, equity, and accessibility for everyone," said CMS Administrator
Chiquita Brooks-LaSure. "This proposed rule reflects our person-centric
approach to better measure health care quality and safety in hospitals to
reduce preventable harm and our commitment to ensure that people with Medicare
in rural and underserved areas have improved access to high-quality health
care."
For
acute care hospitals paid under the IPPS that successfully participate in the
Hospital Inpatient Quality Reporting program and are meaningful electronic
health record users, the proposed increase in operating payment rates for FY
2024 is projected to be 2.8%. This reflects an FY 2024 projected hospital
market basket update of 3.0%, reduced by a projected 0.2 percentage point productivity
adjustment. For FY 2024, CMS expects the proposed increase in operating and
capital IPPS payment rates would generally increase hospital payments by $3.3
billion. For LTCHs, CMS proposes to increase the LTCH PPS standard Federal
payment rate by 2.9%. Overall, CMS expects LTCH payments under the
dual-rate payment system to decrease by 0.9%, or $24 million, primarily due to
a projected decrease in high-cost outlier payments in FY 2024 compared to FY
2023.
"With
this proposed rule, CMS is more accurately paying hospitals and recognizing for
the first time that homelessness, as a social determinant of health, also
impacts resource utilization," said CMS Deputy Administrator Dr. Meena
Seshamani. "Creating incentives for hospitals to provide excellent care for
underserved populations lays the foundation for a health system that delivers
higher-quality, more equitable, and safer care for everyone."
Advancing Health Equity
CMS
is proposing to make health equity adjustments in the Hospital Value-Based
Purchasing Program by providing incentives to hospitals to perform well on
existing measures and to those who care for high proportions of underserved
individuals, as defined by dual eligibility status. This builds on
previous efforts to advance health equity through the finalized health equity
adjustment in the Medicare Shared Savings Program and finalized policies in
Medicare Advantage and Part D Star Ratings Program. CMS also proposes to
recognize the higher costs that hospitals incur when treating people
experiencing homelessness, when hospitals report social determinants of health
codes on claims. In addition, CMS is requesting comment on how to further
support safety-net hospitals.
CMS
is also proposing that rural emergency hospitals could be designated
as graduate medical education training sites. As a result, more medical
residents would be able to train in rural settings, which can help address
workforce shortages in these communities. This proposal builds on other policies to support access to care in
rural and other underserved communities.
Promoting Patient Safety
Consistent
with the CMS National Quality Strategy and the HHS National Healthcare System Action Alliance to Advance
Patient Safety goals to promote the highest quality outcomes and
safest care for all individuals, the proposed set of quality measures aims to
foster safety and equity, and to reduce preventable harm in hospital settings.
Among this set is a proposal to measure the rate of patients and residents in
long-term care hospitals who are up to date on their COVID-19 vaccinations and
new, additional measures for screenings for cancer and social drivers of
health.
For a
fact sheet on the proposed payment rule, visit: https://www.cms.gov/newsroom/fact-sheets/fy-2024-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective
The FY 2024 IPPS/LTCH PPS proposed rule has a 60-day comment period. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2023-07389/medicare-program-proposed-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals
Originally published by Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) and available on CMS.gov, "CMS Proposes Policies to Improve Patient Safety and Promote Health Equity," Extracted 04/10/2023 via URL Source: https://www.cms.gov/newsroom/press-releases/cms-proposes-policies-improve-patient-safety-and-promote-health-equity