The AHA had a mixed reaction to a provision in the rule related to long-term acute-care hospitals. While the AHA approves of delaying implementation of the so-called 25% rule for these facilities, the organization said it is “troubled” that the provision does not apply to all of those facilities next year. “Leaving the proposal as is could arbitrarily prohiit some patients from receiving needed long-term care,” the AHA statement said.
The rule also suggests changes to the Hospital Inpatient Quality Reporting program, which currently has 72 quality measures. The CMS proposes to set the number of measures at 59 in fiscal 2015 and 60 for fiscal 2016. For long-term-care hospitals, the CMS has proposed five measures for fiscal 2016: the percentage of nursing home residents who were assessed and appropriately given the season influenza vaccine; the percentage of residents who were assessed and given the pneumococcal vaccine; influenza vaccination coverage among healthcare personnel; ventilator bundle; and restraint rate per 1,000 days.
Beginning in 2013, the hospital value-based purchasing program required in the Patient Protection and Affordable Care Act will adjust hospital payments based on how hospitals perform or improve performance on a set of quality measures. Under the new rule, the CMS proposes to add the Medicare spending-per-beneficiary measure to the hospital VBP program, which would affect payments starting in 2015.
In a statement, the Premier healthcare alliance said this move would result in putting “reimbursements at risk” because, the group contended, the measure is unproven.
“While the measure in principle has merit, it still has not been tested and can't be replicated,” according to the statement. “The end result is a lack of national data that hospitals can use to verify CMS' calculations, determine the appropriateness of the methodology, or analyze true differences in performance.”
Meanwhile, the Consumer-Purchaser Disclosure Project—a coalition of employer, consumer and labor organizations that promotes access to publicly reported healthcare performance information—lauded HHS for the proposed rule, which the group says links payment to accountability for patient safety. The organization, which includes groups such as the AARP, the American Hospice Foundation, the Leapfrog Group, the National Business Coalition on Health and the Massachusetts Group Insurance Commission, said it plans to submit its comments to the CMS by the June 25 deadline for public comments.