The Centers for Medicare & Medicaid Services (CMS) has released the fiscal year 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) rule. Here is a summary of three major changes.

Higher payment rate

Acute care hospitals paid under IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful electronic health record users will see an increase in operating payment rates of 4.3 percent. The proposed rule projected an increase of 3.2 percent. CMS said this is the highest market basket update in the last 25 years, due to higher expected growth in compensation prices for hospital workers. Long-term care hospitals will see an increase of 2.4 percent or $71 million.

“CMS is taking action to support hospitals, including updating payments to hospitals by a significantly higher rate than in the proposed IPPS final rule, CMS Administrator Chiquita Brooks-LaSure said in an announcement. “This final rule aligns hospital payments with CMS’ vision of ensuring access to health care for all people with Medicare and maintaining incentives for our hospital partners to operate efficiently.”

Adds three health equity-focused measures

To address health care disparities in hospital inpatient care, CMS said it is adopting health equity-focused measures in the IQR Program that will:

  • Assess 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
  • Capture screening and identification of patient-level, health-related social needs—such as food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety.

CMS said by screening for and identifying such unmet needs, hospitals will be in a better position to serve patients holistically by addressing and monitoring what are often key contributors to poor physical and mental health outcomes.

Aims to improve maternal health outcomes

CMS will create a new hospital designation in fall 2023 to identify “Birthing-Friendly” hospitals and additional quality measure reporting to drive improvements in maternal health outcomes. It is the first-ever hospital quality designation by the Department of Health and Human Services that specifically focuses on maternal health.

The new hospital designation will provide information to consumers about hospitals with a demonstrated commitment to reducing maternal morbidity and mortality by implementing best practices that advance health care quality and safety for pregnant and postpartum patients. In the future, CMS may add measures that are equity-focused and measures that capture patient-reported outcomes or experiences of care.

The goal, CMS said in a fact sheet, is not simply to grant hospitals a “maternal health gold star,” but to do so in way that is meaningful for patients and families in search of facilities with a demonstrated commitment to the delivery of high-quality, safe, and equitable maternity care.

For more information, click here for the unpublished final rule. The document is scheduled to be published in the Federal Register on August 10.