CMS issues FY 2019 hospital IPPS proposed rule

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) on April 24 issued its hospital inpatient prospective payment system (IPPS) proposed rule for FY 2019.

The proposed rule increases rates by 1.75%, which reflects the projected market-basket update of 2.8% for hospitals that were meaningful users of electronic health records in FY 2017 and that submit data on quality measures, less a productivity cut of 0.8% and an additional market-basket cut of 0.75%, as mandated by the Affordable Care Act.

Other proposed changes include:

• CMS will begin implementing its Meaningful Measures initiative across its hospital quality reporting and pay-for-performance programs. The proposal will remove 18 measures from the inpatient quality reporting program and de-duplicate 21 measures so they would be used only in one rather than multiple programs.
• The scoring approach will be updated for hospital-acquired conditions, readmissions, and value-based purchasing programs.
• CMS proposes renaming the Meaningful Use program to “Promoting Interoperability,” and introducing a more flexible performance-based approach for determining if a hospital has met the requirements to avoid a Medicare payment penalty. Hospitals would have to use 2015 edition certified electronic health record technology and report performance for a 90-day period in 2019 and 2020.
• The rule proposes that hospitals report at least four electronic clinical quality measures for one self-selected quarter of 2019 data, and reduce the number of eligible electronic clinical quality measures.

The deadline for submitting comments on the proposed rule is June 25, 2018.