The Centers for Medicare and Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) Proposed Rule for fiscal year 2024. Highlights of the proposed rule include a projected 2.8% increase in operating payment rates for general acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting Program (IQR) and are meaningful electronic health record users. This reflects a projected FY 2024 hospital market basket increase of 3.0%, reduced by a 0.2 percentage point productivity adjustment. It is estimated that the percentage increase to the IPPS will equate to an approximate $3.3 billion in additional IPPS hospital payments.

Health equity was also prevalent throughout the rule, with 15 new health equity hospital categorizations proposed for the FY 2024 IPPS payment impacts to expand the collection, reporting and analysis of standardized health equity data. CMS is also seeking public input on how to advance health equity by addressing challenges faced by safety-net hospitals that provide essential services to populations facing barriers to accessing health care, including people from racial and ethnic minority groups, LGBTQ+ community, rural communities and members of historically underserved groups. Additionally, the rule proposes updates to the Hospital Value-Based Purchasing Program, including adopting a health equity scoring change for rewarding excellent care in underserved populations, such that a health equity adjustment would be added to hospitals’ Total Performance Scores.

Other highlights include:

• A proposal to increase the severity designation of three ICD-10-CM diagnosis codes describing homelessness (e.g. unspecified, sheltered, unsheltered) from non-complication or comorbidity to complication or comorbidity to address the level of resources required of hospitals to treat this population
• Proposed changes to the Graduate Medical Education program to promote graduate medical training in Rural Emergency Hospitals
• A reminder that COVID-19 Add-on Payments will expire on Sept. 30, 2023, per the FY 2022 IPPS Final Rule, presuming the public health emergency concludes in May 2023
• A proposal to revise and clarify regulations regarding expansion exceptions requests for Physician-Owned Hospitals
• Proposed changes to the Hospital IQR including adding three new measures, removing three existing measures and modifying three current measures
• Updating Medicare’s Promoting Interoperability Program

ACC Advocacy staff are reviewing the proposed rule to identify any additional topics of interest to cardiovascular clinicians. More information will be provided on ACC.org and in upcoming issues of The Advocate newsletter in the coming weeks. The ACC will submit comments to CMS by the June 9 deadline.

For more information, access the CMS press release and fact sheet.

Clinical Topics: Cardiovascular Care Team, COVID-19 Hub

Keywords: Sexual and Gender Minorities, Electronics, Comorbidity, Hospitals, Rural, COVID-19, Minority Groups, Medicaid, Rural Population, Vulnerable Populations, Inpatients, International Classification of Diseases, Medicare, Centers for Medicare and Medicaid Services, U.S., ACC Advocacy

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