On Aug. 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for inpatient and long-term care hospitals that builds on the Biden-Harris administration’s key priorities to advance health equity and improve maternal health outcomes. The rule updates Medicare payments and policies for hospitals, drives high-quality, person-centered care and promotes fiscal stewardship of the Medicare program. In addition, the rule finalizes new measures to encourage hospitals to build health equity into their core functions.
The rule includes three health equity-focused measures in the Hospital Inpatient Quality Reporting (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 (beginning with CY 2023 reporting period/FFY 2025 payment determination).
The second and third measures (voluntary reporting for CY 2023) capture screening and identification of patient-level, health-related social needs—such as food insecurity, housing instability, transportation needs, utility difficulties and interpersonal safety. 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 (reporting mandatory CY 2024 reporting period/FFY 2026 payment determination).
In the near future, CMS is also interested in using measures focused on connecting patients with identified social needs to community resources or services.
Additionally, The Joint Commission is also implementing new health care equity standards for Joint Commission-accredited hospitals and critical access hospitals. These standards, effective Jan. 1, 2023, are the first of several steps in which The Joint Commission plans to assist organizations to better assess and improve the quality and safety of care for all populations served. Read more about the new standards in the R3 Report
WHA has created an online toolkit
to assist hospitals navigate the CMS and accreditation requirements around health equity and social determinants of health. The Advancing Health Equity Toolkit includes links to important resources such as the IPPS rule, R3 report published by the Joint Commission, video recordings and slide decks from the 4-part Journey to a Healthier Wisconsin
webinar series, and data tools developed by WHA, such as the Community Health Needs Assessment and Health Equity Organizational Assessment Dashboards.
For more information, contact WHA Chief Quality Officer Nadine Allen