CMS is planning to suppress data on many dangerous medical and surgical complications in hospitals because data from the COVID-19 era may be unreliable.
The plan would suppress data on sepsis, kidney harm, deep bedsores, lung collapse, and many other measures. Hospitals report these medical and surgical complications as part of the CMS Patient Safety and Adverse Events Composite or CMS PSI 90 included in the 2023 Hospital Inpatient Prospective Payment System proposed rule.
CMS has proposed not reporting some measures in the Hospital Value-Based Purchasing (VBP) Program Hospital-Acquired Condition (HAC) Reduction Program due to the effect of the COVID-19 public health emergency on measure data.
“[We are] proposing to suppress several measures in the Hospital VBP and HAC Reduction Programs. In addition to these measure suppressions for the Hospital VBP Program, we are proposing to implement a special scoring methodology for FY 2023 that results in each hospital receiving a value-based incentive payment amount that matches their 2% reduction to the base operating DRG [diagnosis-related group] payment amount,” the agency wrote. “Similarly, we are also proposing to suppress all six measures in the HAC Reduction Program for the FY 2023 program year. If finalized as proposed, for the FY 2023 program year, hospitals participating in the HAC Reduction Program will not be given a measure score, a Total HAC score, nor will hospitals receive a payment penalty.”1
The Leapfrog Group strongly opposes the proposal, says Missy Danforth, vice president of healthcare ratings.
“We are significantly disturbed about this. We are putting together a huge campaign to try to get individuals and organizations to reverse course on this,” Danforth says.
CMS and the CDC recently reported healthcare-associated infections have increased over the last two years. Danforth notes that The Leapfrog Group’s recent analysis shows the patient experience has gotten worse at the same time.2
“We really need to see what’s going on with medical and surgical complications, and CMS is proposing to suppress that data all the way until 2024,” Danforth says. “At a time when it’s maybe more dangerous than ever to go to a hospital, we don’t want them to hide these data from the public. We think it can be life-threatening.”
REFERENCES
- Centers for Medicare & Medicaid Services. FY 2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals (LTCH PPS) Proposed Rule — CMS-1771-P. April 18, 2022.
- The Leapfrog Group. Patient Experience During the Pandemic: Adult Inpatient Care. May 10, 2022.
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