CMS Final Rule Improves Health Equity,
Access to Treatment, Hospital Readiness, and COVID-19 Vaccination Data
Reporting of Hospital Workers
Hospital
Inpatient Prospective Payment System Final Rule Increases Payments to
Treat COVID-19 and Improves Quality of Data Collection
CMS is taking action to drive
value-based, person-centered care and promote sustainability and
readiness to respond to future Public Health Emergencies (PHEs) in our
nation’s hospitals through the Hospital Inpatient Prospective Payment System/Long
Term Care Hospital (LTCH) Prospective Payment System final rule.
The final rule, effective October 1,
2021, authorizes additional payments for diagnostics and therapies to
treat COVID-19 during the current PHE, and beyond. The rule revises
payment policies, as well as policies under certain quality and
value-based purchasing programs for hospitals to lessen the adverse
impacts of the pandemic. Some of these changes will incentivize the
meaningful use of certified Electronic Health Record (EHR) technology
that will help public health officials monitor for future unplanned
events.
“How Medicare pays for hospital care and
evaluates quality, are integral pieces of achieving and addressing gaps
in health equity and strengthening our health care system for a more
sustainable future. CMS is moving forward to incorporate what we have
learned from the COVID-19 pandemic in order to improve quality and
increase transparency so that patients are positioned to make informed
decisions about their care,” said CMS Administrator Chiquita
Brooks-LaSure. “With this final rule, we are further improving how we
measure and evaluate data while investing in quality care for people that
rely on Medicare for coverage.”
Last week, CMS also finalized a number of
other Medicare payment rules including for skilled nursing facilities, inpatient rehabilitation facilities, inpatient psychiatric facilities, and hospice providers. Using lessons learned
from the COVID-19 pandemic, these final rules will enact policies that
will further protect and deliver better care to Medicare beneficiaries.
These payment rules finalized new quality measures to give beneficiaries
and their families better insights into the quality of care rendered at
hospice facilities and vaccination reporting of facility staff.
Improving Health Equity:
In an effort to advance equity through
the quality reporting measurement, CMS solicited feedback on
opportunities to leverage diverse data sets such as race, ethnicity,
Medicare/Medicaid dual eligible status, disability status, LGBTQ+, and
socioeconomic status. The agency received more than 200 comments,
reflecting the importance stakeholders place on this Biden-Harris
Administration priority. CMS will consider the feedback it received to
inform future actions.
“Standardization of equity data to
improve hospital data collection is just one more way CMS will lead the
national conversation on improving health equity,” said Brooks-LaSure.
“CMS will use these comments and innovate on quality measures to help
identify health equity data. We’re also measuring hospital initiatives to
improve maternal health outcomes as we work to reduce disparities in
maternal morbidity.”
Addressing the maternal health crisis and
improving maternal health is a priority to advance health equity and a
quality improvement goal for CMS. To that end, CMS is adding a Maternal
Morbidity measure to the hospital quality reporting program that would
require hospitals to report whether they participate in statewide or
national efforts to improve perinatal health, known as Quality
Improvement initiatives. Many of the factors contributing to maternal
morbidity are preventable and differentially impact women of color. This
measure is an important initial step toward implementation of patient
safety practices to reduce maternal morbidity, and in turn, maternal
mortality.
CMS is also adopting a measure that
requires hospitals and LTCHs to report COVID-19 vaccination rates of
workers in their facilities. Having access to information about COVID-19
vaccination rates among health care personnel will help patients,
caregivers, and their communities make informed decisions when seeking
care from hospitals, cancer centers, and LTCHs.
Ensuring Access to Life-Saving
Diagnostics and Therapeutics:
In November 2020, CMS established the New
COVID-19 Treatments Add-on Payment (NCTAP) to encourage hospitals to
provide new COVID-19 treatments during the PHE. CMS is finalizing its
proposal to extend the NCTAP for certain eligible technologies through
the end of the fiscal year in which the PHE ends to continue to encourage
these new treatments and to minimize any potential payment disruption
immediately following the end of the PHE. These products include
currently approved hospital treatments. Providing these therapies to
COVID-19 patients early can help reduce hospital stays and deaths.
Sustaining Hospital Readiness to Respond
to Future Public Health Threats:
Strengthening public health functions
through methods such as early warning surveillance, case surveillance,
and vaccine uptake increases information available to the public and
helps hospitals better serve their patients. CMS continues its ongoing
response to the PHE and future health threats by promoting the meaningful
use of certified EHR IT to report data that supports public health
efforts. Specifically, CMS is modifying the Promoting Interoperability Program
for eligible hospitals and critical access hospitals to expand required
reporting within the Public Health and Clinical Data Exchange Objective.
The final rule requires hospitals to
attest they are in active engagement with public health agency to submit
data for measures related to nationwide surveillance for early warning of
emerging outbreaks and threats; automated case and laboratory reporting
for rapid public health response; and visibility on immunization coverage
so public health agencies can tailor vaccine distribution strategies.
Hospital reporting of the measures will support public health agencies as
they prepare to respond to both future health threats and long-term
COVID-19 recovery.
More Information:
The
Medicare Learning Network®, MLN Connects®, and MLN Matters®
are registered
trademarks of the U.S. Department of Health and Human Services
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