CMS IPPS Policies Set to Advance Public Health Data Exchange

Policies in the CMS 2023 Inpatient Prospective Payment System (IPPS) final rule aim to advance public health data exchange, according to an ONC HealthITBuzz blog post.

The 2023 IPPS rule expands the list of required public health measures under the CMS Promoting Interoperability Program to include antimicrobial use and resistance (AUR) surveillance.

Beginning in 2024, hospitals must report AUR data to CDC’s National Healthcare Safety Network (NHSN) to earn full credit under the Public Health Objective.

Hospitals must use health IT certified under ONC’s certification program to the “Transmission to public health agencies — antimicrobial use and resistance reporting” certification criterion to complete this reporting.

“While this capability has been included in the ONC Health IT Certification Program since 2015, and many hospitals are already tracking AUR data, this new, dedicated measure will help to ensure this important reporting activity is conducted at a national scale,” Alex Baker and Elisabeth Myers of ONC wrote in the blog post.

CMS has also increased the points available under the Public Health and Clinical Data Exchange Objective.

Starting in 2024, CMS will require that hospitals show progress toward data exchange with public health agencies by limiting the time an eligible hospital can spend on registration or testing activities before moving to full production.

“These changes acknowledge advances in data modernization, widespread technical capabilities in public health agencies to receive standardized data from providers, and the critical role that public health reporting plays in responding to public health emergencies, and closing gaps and inconsistencies revealed—and exacerbated—by the COVID-19 pandemic,” Baker and Myers wrote.

The 2023 IPPS final rule also adds new health equity-focused measures (voluntary for 2023 but required beginning in 2024) under the Hospital Inpatient Quality Reporting (IQR) program.

The measures assess:

• The degree of hospital leadership commitment to collecting health equity performance data
• The percent of patients admitted to the hospital who are 18 years or older at the time of admission and are screened for food insecurity, housing instability, transportation problems, utility help needs, and interpersonal safety
• The proportion of patients who screened positive on the date of hospital admission for one or more of these health-related social needs

As part of the final rule, CMS encouraged hospitals to capture this data using screening tools that record information in a standardized format.

“By using tools that capture the social drivers of health screening results in a standardized way, hospitals can ensure this critical information is available to other providers delivering care and services to a patient, including community-based organizations that receive referrals to support individuals’ social needs,” the blog post noted.

A stakeholder coalition called Sync for Social Needs will help test and demonstrate best practices for standardizing and digitizing related processes in response to these new CMS requirements.