America’s Essential Hospitals and its members are committed to improving quality by reducing hospital-acquired conditions (HACs) that create serious adverse outcomes for patients and lowering the number of preventable readmissions. Essential hospitals are at the forefront of using evidence-based guidelines to prevent HACs and improve the overall patient experience.
National efforts to track hospital quality include public reporting of quality rating information and use of performance measures to link quality to payment. In that context, it becomes critically important to measure outcomes and align measures across care settings.
Our Members’ Performance on Selected Process of Care Measures
But measures often fail to account for social and economic challenges vulnerable patients face and that a hospital has little or no ability to control. Without risk adjusting measures for these socioeconomic factors, quality incentive programs disproportionately penalize essential hospitals, which already operate with a zero margin, on average. This creates a vicious circle in which quality erodes further because hospitals lose the very funding they need for improvements.
America’s Essential Hospitals advocates for quality improvement program measures that are properly constructed, risk adjusted for factors beyond the control of the hospital, and that do not lead to unintended consequences for, and administrative burdens on, essential hospitals.
This is the second star ratings update since the agency updated its methodology in 2020 to include the use of peer grouping.view more »
A proposed rule for Medicare’s Outpatient Prospective Payment System for calendar year 2023 would reverse Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program, continue site-neutral payment policies, and revise the inpatient-only list, among other proposed changes.view more »
The National Steering Committee for Patient Safety calls on health care providers to put its 2020 Action Plan into practice.view more »
Hospitals have until June 16 to preview their Overall Hospital Quality Star Rating, measure group score, and individual measure results, along with peer grouping.view more »
The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.view more »
Due to a calculation error in measure results used for calendar year 2021 public reporting, the Centers for Medicare & Medicaid Services has delayed until July the overall hospital star ratings update originally scheduled for April.view more »
HHS awarded $103 million to improve health care worker retention by reducing staff burnout and promoting mental wellness. Several essential hospitals were among the awardees, including the University of New Mexico, Virginia Commonwealth University, and the University of Utah.view more »
In response to the proposed rule for the 2023 plan year, the association urged the Department of Health and Human Services to ensure equitable access, finalize nondiscrimination policies, standardize collection of Z codes, and prorate premiums and advanced premium tax credits.view more »
Vice President Kamala Harris hosted the first federal Maternal Health Day of Action. Coinciding with the event, America’s Essential Hospitals announced 12 member hospitals will participate in a new CVS Health Foundation–funded learning collaborative to improve maternal health.view more »
Final rules for Medicare’s OPPS and PFS for CY 2022 continue Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program; continue site-neutral payment policies; and halt elimination of the inpatient-only (IPO) list.view more »
The Centers for Medicare & Medicaid Services published updated overall hospital quality star ratings on its Care Compare website; the ratings were last updated in January 2020. America’s Essential Hospitals has expressed continued concern about the fairness and reliability of the ratings.view more »
Hospitals have 30 days to review their reports before public reporting to Care Compare.view more »
The proposed rule builds on a CMS final rule on interoperability and patient access; it would leverage application programming interfaces to improve patients’ access to their electronic health information and reduce burden on providers related to prior authorization.view more »
The next phase of the Maternal and Infant Health Initiative (MIHI) includes a new focus on postpartum care visits, well-child visits, and decreasing rates of cesarean-section births in low-risk pregnancies. A work group developed a set of recommendations and a report on next steps for the MIHI.view more »
Final rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule for calendar year 2021 continue Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program and site-neutral payment policies.view more »
The Department of Health and Human Services released a detailed action plan on maternal health and announced a public-private partnership to reduce maternal mortality and morbidity. The surgeon general simultaneously announced a call to action to improve maternal health, complementing HHS’ plan.view more »
The Centers for Medicare & Medicaid Services (CMS) on Dec. 1 will retire its original Hospital Compare tools, encouraging users to visit Medicare.gov’s new Care Compare tool to find and compare health care providers. CMS will not update the overall hospital quality star ratings in January 2021.view more »
The proposed rule would increase inpatient payment rates by 3.1 percent, reduce Medicare disproportionate share hospital payments by about $0.9 billion compared with fiscal year 2020, and collect median third-party charge data on Medicare cost reports.view more »
CMS releases guidance for hospitals in quality reporting programs; CDC updates guidelines for testing and handling COVID-19 specimens.view more »
Both chambers passed a bill providing more than $8 billion to combat the new coronavirus; House leaders now are discussing legislation to mitigate economic impacts associated with the virus. A Senate letter calling to incorporate social determinants into hospital star ratings closes tomorrow.view more »
HHS Secretary Alex Azar will discuss the president’s proposed fiscal year 2021 budget at several congressional hearings. A bipartisan Senate letter calls for incorporating social determinants into star ratings. A new association work group focuses on the Medicaid Fiscal Accountability Regulation.view more »
The report is based on feedback gathered during a September listening session, in which more than 300 stakeholders shared recommendations for improving predictability, stability, and relevance of star ratings.view more »
States are leveraging financial incentives, quality measures, waivers, and public-private partnerships to slow climbing rates of substance use disorder and overdose among pregnant women.view more »
The association expressed support for the Substance Abuse and Mental Health Services Administration’s proposed revisions to confidentiality of records for patients with substance use disorders, while outlining remaining barriers to care coordination.view more »
The 18-month grants, awarded to 15 state Medicaid agencies, seek to increase the ability of providers to deliver substance use disorder treatment and recovery services.view more »
An NEJM Catalyst article assesses four public hospital quality reporting programs’ ability to classify hospital performance.view more »
The agency plans to update the Overall Hospital Quality Star Ratings methodology in 2021 and will host a Sept. 19 listening session to seek stakeholder feedback.view more »