The Centers for Medicare and Medicaid Services (CMS) released their Inpatient Prospective Payment System (IPPS) Proposed Rule and Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) Proposed Rule in May.
For the Hospital IQR Program, CMS proposes the following:
- Adoption of two new electronic clinical quality measures (eCQMs) to the eCQM measure set
- Safe Use of Opioids – Concurrent Prescribing
- Hospital Harm – Opioid-Related Adverse Events
- Adoption of the Hybrid Hospital-Wide Readmission(HWR) measure beginning with two years of voluntary reporting
- Removal of the claims-based version of the HWR measure when the hybrid version of the measure becomes mandatory
CMS is inviting public comment on the following possible future eCQMs:
- Hospital Harm – Severe Hypoglycemia
- Hospital Harm – Pressure Injury
- Cesarean Birth (PC-02)
The following chart abstracted measures are proposed to continue through at least Fiscal Year 2024, (Calendar Year 2022 discharges):
- PC-01: Elective Delivery
- Sepsis: Severe Sepsis and Septic Shock Management Bundle
For the Inpatient Psychiatric Facility Quality Reporting (IPFQR Program) CMS proposes the following:
- Adoption of the Medication Continuation Following Inpatient Psychiatric Discharge Measure –(NQF#3205)
- This claims based measure would use Medicare fee-for-service claims to calculate a 24 month performance period.
- Measures the percentage of patients discharged from a psychiatric facility with a principal diagnosis of MDD, schizophrenia, or bipolar disorder who filled evidence-based medication within two days prior through 30 days post discharge.
The following chart abstracted measures are to continue through at least Fiscal Year 2021 (Calendar Year 2019 discharges):
- HBIPS-2: Hours of Physical Restraint Use
- HBIPS-3: Hours of Seclusion Use
- HBIPS-5 Patients Discharged on Multiple Antipsychotic Medications with Appropriate Justification
- SUB-2 & 2a: Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention SUB-3 and 3a: Alcohol and Other Drug use Disorder Treatment Provided or Offered at Discharge and Alcohol and Other Drug Use Disorder Treatment at Discharge.
- TOB-2 &2a: Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment
- TOB-3 & 3a: Tobacco Use Treatment Provided or Offered at Discharge and Tobacco Use Treatment at Discharge.
- IMM-2: Influenza Immunization
- Transition Record: Transition Record with Specified Element Received by Discharged Patients & Timely Transmission of Transition Record
- Screening for Metabolic Disorders
The final rules are expected to be published sometime later this year.
The FY2019 IPPS Proposed Rule can be downloaded from the Federal Register at https://www.govinfo.gov/content/pkg/FR-2019-05-03/pdf/2019-08330.pdf
The FY2019 IPF PSS Proposed Rule can be downloaded from the Federal Register at https://www.federalregister.gov/documents/2019/04/23/2019-07884/medicare-programfy-2020-inpatient-psychiatric-facilities-prospective-payment-system-and-quality