
Quality Improvement
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

Source: 2014 Essential Data: Our Hospitals, Our Patients — Results of America’s Essential Hospitals 2014 Annual Member Characteristics Survey.
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.
July 2023 Hospital Overall Star Ratings Preview Reports Available
May 5, 2023 ||Hospitals have until June 1 to preview their Overall Hospital Quality Star Rating, measure group score, individual measure results, and peer grouping.
view more »CMS Issues FY 2024 IPPS Proposed Rule
April 24, 2023 ||The proposal includes numerous policy and payment changes to Medicare’s Inpatient Prospective Payment System for fiscal year 2024, including a 2.8 percent increase in inpatient payment rates.
view more »CMS Updates QAPI Program Evaluation Guidance
March 13, 2023 ||The updated guidance highlights the importance of sustaining a QAPI program over time and increasing engagement by the hospital’s governing body.
view more »New York Invests in Hospitals to Catalyze Care Improvement
March 7, 2023 ||Two grants from the Statewide Health Care Facility Transformation Program will support emergency department expansion and health care delivery projects.
view more »Essential Hospital Designation
Feb. 24, 2023 ||Our proposal would codify a designation of essential hospitals in statute, allowing lawmakers to better target support to improve access to care and public health.
view more »HHS Proposes Revisions to Confidentiality of Substance Use Disorder Patient Records
Dec. 13, 2022 ||Changes in the proposed rule seek to improve care coordination among providers and increase protections for substance use disorder patients to mitigate discrimination during treatment.
view more »Protect and Strengthen the Health Care Workforce
Dec. 5, 2022 ||The United States faces a significant and pervasive health care workforce shortage, especially in underserved communities. As policymakers discuss how to address current and future workforce shortages, we urge Congress to expand, protect and fund the health care workforce.
view more »Extend Telehealth and Hospital-At-Home Flexibility
Dec. 5, 2022 ||As Congress continues to consider legislation during and after the pandemic, it should make permanent policies that allow providers to expand access to care, including telehealth and hospital-at-home, to improve the health of their communities.
view more »CMS Releases Hospital Workplace Violence Memo
Nov. 29, 2022 ||The memo reviews regulatory obligations to care for patients in a safe environment, including the need to identify patients at risk for intentional harm to themselves or others.
view more »CY 2023 PFS Final Rule Includes Telehealth, Equity Provisions
Nov. 15, 2022 ||The final rule for calendar year 2023 continues certain flexible telehealth policies, overhauls the Medicare Shared Savings Program, and revises the Quality Payment Program.
view more »CY 2023 OPPS Final Rule Includes 340B, Site-Neutral, and Quality Provisions
Nov. 14, 2022 ||The final rule reverses Medicare Part B drug payment cuts to hospitals in the 340B Drug Pricing Program, continues site-neutral payment policies, and revises the inpatient-only list, among other proposed changes.
view more »CMS Innovation Center Shares Progress Report, Specialty Care Plans
Nov. 10, 2022 ||The CMS Innovation Center shares a progress report on its 10-year strategy and a blog post announcing plans to improve integrated specialty care.
view more »Oregon Approves $40M for Hospital Overcrowding
Oct. 11, 2022 ||The majority of the funding is dedicated to mitigating bed shortages at hospitals and long-term care facilities through increased staffing.
view more »HHS Releases Behavioral Health Integration Roadmap
Sept. 23, 2022 ||The roadmap implements the three pillars of the President’s March 2022 Strategy to Address our National Mental Health Crisis.
view more »CMS Releases July 2022 Overall Hospital Star Ratings
Aug. 2, 2022 ||This is the second star ratings update since the agency updated its methodology in 2020 to include the use of peer grouping.
view more »CY 2023 OPPS Rule Includes 340B, Site-Neutral, and Quality Proposals
July 25, 2022 ||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 »CY 2023 PFS Proposed Rule Released
July 19, 2022 ||A proposed rule for the Medicare Physician Fee Schedule for calendar year 2023 would extend telehealth regulatory flexibility, make changes to the Medicare Shared Savings Program, and revise the Quality Payment Program.
view more »NSC Urges Commitment to Patient and Workforce Safety
June 13, 2022 ||The National Steering Committee for Patient Safety calls on health care providers to put its 2020 Action Plan into practice.
view more »July 2022 Hospital Overall Star Ratings Preview Reports Available
June 7, 2022 ||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 »CMS Delays Hospital Star Ratings Update Until July
Feb. 15, 2022 ||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 Awards $103M to Reduce Provider Burnout, Support Mental Health
Jan. 24, 2022 ||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 »Association Comments on Notice of Benefit and Payment Parameters
Jan. 24, 2022 ||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 »Biden Administration Issues Call to Action on Maternal Health
Dec. 7, 2021 ||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 »Details of CY 2022 OPPS, PFS Final Rules
Nov. 18, 2021 ||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 »CMS Issues FY 2022 IPPS Final Rule
Aug. 20, 2021 ||The rule includes numerous policy and payment changes for Medicare’s Inpatient Prospective Payment System for fiscal year 2022, including a 2.5 percent increase in inpatient payment rates.
view more »Overall Hospital Star Ratings Updated on Care Compare
May 3, 2021 ||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 »CMS Releases Hospital Star Rating April Preview Reports
Feb. 2, 2021 ||Hospitals have 30 days to review their reports before public reporting to Care Compare.
view more »CMS Proposes to Streamline Prior Authorization, Patient Access to Data
Jan. 5, 2021 ||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 »CMS Launches Next Phase of Maternal, Infant Health Initiative
Jan. 5, 2021 ||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 »CY 2021 OPPS, PFS Rules Include 340B, Site-Neutral, and Star Rating Policies
Dec. 18, 2020 ||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 »Maternal Health Action Plan, Call to Action
Dec. 8, 2020 ||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 »CMS Retires Hospital Compare; No Star Ratings Update in Jan.
Nov. 20, 2020 ||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 »NQF Guidance: Designing Measure Sets and Systems
Aug. 11, 2020 ||A new report, from a National Quality Forum (NQF) 25-person technical expert panel, provides insight on how quality measures can be combined in a system to improve health outcomes and drive high-value care for all.
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