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Essential Hospitals Welcome Equity Focus in IPPS Proposed Rule


Statement attributable to:
Bruce Siegel, MD, MPH
President and CEO
America’s Essential Hospitals

WASHINGTON — We are pleased by the extensive focus on improving health care equity and reducing health disparities in the fiscal year (FY) 2023 Medicare Inpatient Prospective Payment System (IPPS) proposed rule.

Essential hospitals embrace and champion equity with their mission to serve underrepresented people and communities. So, we welcome this equity focus as seen in the proposed rule’s requests for information related to the Hospital Readmissions Reduction Program, climate change, and maternal health.

But we caution that meaningful change will require partners and policies outside our hospitals’ circle — housing, education, social services, and other stakeholders who touch upstream factors that influence health. It also will require a sound foundation of evidence, including sociodemographic data, to understand the challenges historically disadvantaged patients face. We must build that foundation first and carefully develop and evaluate meaningful measures linked to outcomes. This is especially important, as hospitals are in varying places on the journey to health equity. We welcome tools and other resources from the Centers for Medicare & Medicaid Services (CMS) to help hospitals continue this crucial work.

Elsewhere in the proposed IPPS rule, we are disappointed to find that uncompensated care–based Medicare disproportionate share hospital (DSH) payments are projected to decline for a third consecutive year. This would undermine vital support for essential hospitals as they recover from the financial stress of the COVID-19 public health emergency, which continues.

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals dedicated to equitable, high-quality care for all, including those who face social and financial barriers to care. Since 1981, America’s Essential Hospitals has advanced policies and programs that promote health, health care access, and equity. We support our more than 300 members with advocacy, policy development, research, education, and leadership development. Communities depend on essential hospitals for care across the continuum, health care workforce training, research, public health and health equity, and other services. Essential hospitals innovate and adapt to lead all of health care toward better outcomes and value. Learn more at

Carl Graziano


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