he Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2023 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) final rule (CMS-1771-F).

Here’s what you need to know:

  • For acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful electronic health record users, the final rule will result in an increase in operating payment rates of 4.3%.
  • Under the LTCH PPS, CMS expects payments in FY 2023 to increase by approximately 2.4% or $71 million.
  • To address health care disparities in hospital inpatient care and beyond, CMS is adopting three health equity-focused measures in the IQR Program.
    • The first measure assesses a hospital’s commitment to establishing a culture of equity and delivering more equitable health care by capturing concrete activities across five key domains, including strategic planning, data collection, data analysis, quality improvement, and leadership engagement.
    • The second and third measures capture screening and identification of patient-level, health-related social needs – such as food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety.
  • The rule also finalized adopting seven other measures to the IQR Program, refining two current measures, making changes to the existing electronic clinical quality measure (eCQM) reporting and submission requirements, removing the zero-denominator declaration and case threshold exemptions for hybrid measures, updating our eCQM validation requirements for medical record requests, and establishing reporting and submission requirements for patient-reported outcome-based performance measures.
  • CMS is also discontinuing the use of proxy data for uncompensated care costs in determining uncompensated care payments for Indian Health Service and Tribal hospitals, and hospitals in Puerto Rico, and are establishing a new supplemental payment to prevent undue long-term financial disruption for these hospitals and to promote long-term payment stability.
  • CMS is also finalizing new flexibilities for graduate medical education for rural hospitals participating in rural track programs, which will help promote workforce development in rural areas.
  • CMS is creating a new hospital designation to identify “Birthing-Friendly” hospitals and additional quality measure reporting to drive improvements in maternal health outcomes. CMS is finalizing this designation following the release of the comprehensive CMS Maternity Care Action Plan.
  • CMS is finalizing the proposed requirements for continued COVID-19-related reporting for hospitals and CAHs with a reduced number of data categories as an off ramp to the current PHE.
  • CMS approved eight technologies that applied for new technology add-on payments for FY 2023.
  • CMS is pausing the Patient Safety and Adverse Events measure (CMS PSI 90 measure) and the five CDC NHSN Healthcare-Associated Infection (HAI) measures from the calculation of measure scores and the Total HAC Score, thereby not penalizing any hospital under the Hospital-Acquired Condition (HAC) Reduction Program FY 2023 program year. CMS will calculate and publicly report the CMS PSI 90 measure displayed on the main pages of the Care Compare tool hosted by HHS after confidentially report these results to hospitals with a 30-day preview period.

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

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