2022 IPPS Proposed Rule
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The 2022 IPPS proposed rule includes changes to the inpatient quality reporting (IQR) program, introducing a mandatory hybrid hospital-wide all-cause mortality measure by 2023, along with the existing hybrid all-cause readmission measure. Hospitals are required to submit specific electronic clinical quality measures (ECQMs) starting from 2021, with some measures being publicly reported beginning in 2023. Additionally, the promoting interoperability program will see changes including a revised reporting period and new ECQMs, aligning with the IQR updates.
2022 IPPS Proposed Rule
- 2. Proposed changes to the Inpatient Quality Reporting (IQR) program. eCQMs & Hybrid Measures
- 3. CMS proposed to add a brand-new hybrid measure to the mix: the Hybrid Hospital-Wide All-Cause Mortality (HWM) measure. Submission of this hybrid measure and the current Hybrid All-Cause Readmission (HWR) measure is mandatory by 2023. Hybrid Measures
- 4. 2021 2022 2023 & 2024 Voluntary reporting for hybrid measure: 1. Hospital-Wide Readmission Reporting year: July 1, 2021 – June 30, 2022
- 5. 2021 2022 Voluntary reporting for hybrid measure: 1. Hospital-Wide Readmission Reporting year: July 1, 2021 – June 30, 2022 Voluntary reporting for hybrid measures: 1. Hospital-Wide Readmission 2. Hospital-Wide Mortality Reporting year: July 1, 2022 – June 30, 2023 2023 & 2024
- 6. 2021 2022 Voluntary reporting for hybrid measure: 1. Hospital-Wide Readmission Reporting year: July 1, 2021 – June 30, 2022 Voluntary reporting for hybrid measures: 1. Hospital-Wide Readmission 2. Hospital-Wide Mortality Reporting year: July 1, 2022 – June 30, 2023 Mandatory reporting for hybrid measures: 1. Hospital-Wide Readmission 2. Hospital-Wide Mortality Reporting year: July 1, 2023 – June 30, 2024 2023 & 2024 Reporting year: July 1, 2024 – June 30, 2025
- 7. In 2023, CMS is proposing to remove the claim- based HWR measure and replace it with the hybrid measure equivalent. All hybrid data submitted in 2023 will be publicly reported. Hybrid Measures
- 8. CMS made no proposed changes to the number of quarters of eCQM data required to be reported (over a 3-year period). eCQM SUBMISSION
- 9. 2021 2022 2023 2 quarters of eCQM data
- 10. 2021 2022 2023 2 quarters of eCQM data 3 quarters of eCQM data
- 11. 2021 2022 2023 4 quarters of eCQM data 2 quarters of eCQM data 3 quarters of eCQM data
- 12. eCQM SUBMISSION Hospitals must still submit only four eCQMs.
- 13. OPIOID MEASURE In 2022, CMS proposes that hospitals must submit the Safe Use of Opioids eCQMs – Concurrent Prescribing as one of their four eCQMs.
- 14. 2021 2022 2023 Any 4 self-selected eCQMs
- 15. 2021 2022 2023 Any 4 self-selected eCQMs Any 3 self-selected eCQMs AND Safe Use of Opioids eCQM
- 16. 2021 2022 2023 Any 3 self-selected eCQMs AND Safe Use of Opioids eCQM Any 4 self-selected eCQMs Any 3 self-selected eCQMs AND Safe Use of Opioids eCQM Must submit the same eCQMs across quarters.
- 17. Remember that the Opioid measure is available for submission in 2021 and required in 2022 so start improving this measure now because your performance will be publicly reported. P.S. Medisolv is already working with our clients on improving this measure! OPIOID MEASURE
- 18. Did you catch that? We said, publicly reported eCQMs and Hybrid measures.
- 19. FROM NOW ON
- 20. Your eCQM performance (starting 2021) for the IQR and Promoting Interoperability programs will be reported publicly on Care Compare. And your Hybrid measure performance starting in 2023 will also be publicly reported. FROM NOW ON
- 21. OTHER CHANGES There were a few changes to the eCQM lists. IN 2023: CMS is adding two new eCQMs • hospital harm-severe hypoglycemia (NQF #3503e) • hospital harm-severe hyperglycemia (NQF #3533e)
- 22. OTHER CHANGES IN 2024: CMS is removing four eCQMs • Exclusive Breast Milk Feeding (PC-05) • Admit Decision Time to ED Departure Time (ED-2) • Anticoagulation Therapy for Afib/flutter (STK-3) • Discharged on Statin (STK-6)
- 23. The Promoting Interoperability program did receive quite a few proposed changes to the program in 2022. PI PROGRAM
- 24. PI PROGRAM 2022: • 90-day EHR reporting period • Increase available points for PDMP measure from 5 to 10 • Maintain electronic health information from 1/1/2016 forward for provide patient access to health information • Addition of health information bi-directional exchange measure to the HIE objective as alternative to the 2 existing HIE measures (40 points)
- 25. PI PROGRAM 2022: • Require 4 public health and clinical data exchange measures (up to 10 points) • Complete an annual assessment via a SAFER guides measure under the protect patient health information objective • Remove statements 2 & 3 from prevention of information blocking • Increase minimum scoring threshold from 50 points to 60 points • Require use of 2015 edition cures update beginning in CY 2023 for all available eCQMs
- 26. PI PROGRAM 2023: • 90-day EHR reporting period • 2 new eCQMs (aligns with IQR) 2024: • 180-day EHR reporting period • Remove 4 eCQMs (aligns with IQR)
- 27. CLARIFICATIONS AND OTHER UPDATES HYBRID • Hospitals must submit within 3 months after the end of the reporting period - No later than October 1st (or first business day). • Lab results must be reported for >90% of admissions for nonsurgical patients. However, hospitals should submit lab values for those surgical patients with lab values available. • There is only one voluntary reporting year for the Hybrid HWM measure, which mostly aligns with the HWR core clinical data elements.
- 28. CLARIFICATIONS AND OTHER UPDATES eCQMs • Measures must be the same across quarters in any given reporting year. • Quarters do not have to be consecutive. • Technical Guidance: Beginning in 2023, hospitals must use certified technology that has been updated consistent with the 2015 Edition Cures Update, and must support reporting requirements for all eCQMs.
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