The Centers for Medicare & Medicaid Services (CMS) has pulled back on plans to pause public reporting on certain hospital safety data in the wake of pushback from patient safety advocates.
In Monday’s release of the final Inpatient Prospective Payment System (IPPS), CMS detailed numerous changes from a fiscal year 2023 proposal it had laid out in April. Among these was a decision to pause a composite measure of 10 patient safety indicators including pressure sores, falls and sepsis called PSI 90.
According to the report by Fiercehealcare.com, the agency would have stopped calculating these composite indicators in hospitals’ quality ratings for Medicare reimbursement and stopped publishing them as part of the Star Ratings found on the government’s Care Compare website.
CMS said at the time its decision was intended to shield hospitals that had been harder hit by the COVID-19 pandemic and, subsequently, received a financial and publicity hit compared with hospitals in less impacted regions.
The agency now seems to have split the difference, announcing Monday that it would maintain public awareness while seeking to avoid the unintended financial penalty.
“CMS will include the measure in Star Ratings in alignment with the feedback we received,” the agency wrote. “Although this measure will be publicly reported, it will not be used in payment calculations in the HAC to avoid unintentional penalties related to the uneven impacts of COVID-19 across the country.”
The agency’s decision received a warm welcome from The Leapfrog Group, a patient safety watchdog that has been petitioning the government via letters, reports and informational webinars to keep the hospital quality measure available to the public.
The agency’s new approach manages to continue reporting composite measures responsible for 25,000 deaths per year without the confounding influence of COVID-19, Leapfrog said in a release. More broadly, the group said it signals the agency’s “powerful support for transparency” and suggests similar data suppression proposals aren’t on the horizon.
“We were gratified to hear CMS reinforce their longstanding commitment to transparency and patient safety,” Leapfrog President and CEO Leah Binder said in a statement. “We thank CMS for their leadership – for listening to and championing patients and families, patient safety advocates, employers, purchasers, clinicians and all Americans who are deeply concerned about patient safety.”
Also calling for the rollback was the National Alliance of Healthcare Purchaser Coalitions. The nonprofit representing private and public sector members had written to CMS warning that the data were vital to purchasers’ decisions when building high-quality networks which, alongside safety concerns, would lead to higher costs and the perpetuation of inequities.