CMS Final Rule Improves Health Equity, Access to Treatment, Hospital Readiness, and More
To achieve value-based, person-centered care, the U.S. healthcare system must promote (https://www.cms.gov/newsroom/press-releases/cms-final-rule-improves-health-equity-access-treatment-hospital-readiness-and-covid-19-vaccination) sustainability and readiness to prepare for future public health emergencies such as the COVID-19 coronavirus pandemic, the Centers for Medicare and Medicaid Service (CMS) said. In August 2021, CMS announced (https://www.cms.gov/newsroom/press-releases/cms-final-rule-improves-health-equity-access-treatment-hospital-readiness-and-covid-19-vaccination) that the Hospital Inpatient Prospective Payment System and Long Term Care Hospital Prospective Payment System final rule will take effect on October 1, 2021, in support of that work.
The rule “authorizes (https://www.cms.gov/newsroom/press-releases/cms-final-rule-improves-health-equity-access-treatment-hospital-readiness-and-covid-19-vaccination) additional payments for diagnostics and therapies to treat the COVID-19 coronavirus in patients during the public health emergency and beyond” under certain quality and value-based purchasing programs to mitigate some of the pandemic’s hardships for hospitals. CMS said (https://www.cms.gov/newsroom/press-releases/cms-final-rule-improves-health-equity-access-treatment-hospital-readiness-and-covid-19-vaccination) that some of the changes will incentivize the use of certified electronic health record technologies that can help public health officials earlier identify health emergencies in the future.
To further advance health equity through the new rule, CMS combed through feedback on opportunities to leverage diverse data sets, including race, ethnicity, LGBTQ+ identity, Medicare and Medicaid dual eligible status, disability status, and socioeconomic status. The data also help to address and improve the maternal health crisis.
The rule includes several COVID-19–related measures, such as:
- Requires hospitals and long-term care hospitals to report COVID-19 vaccination rates among staff, which in turn will help patients, caregivers, and their communities make informed decisions when seeking care
- Extends the new COVID-19 treatments add-on payment for certain eligible technologies through the end of fiscal year 2021
- Strengthens public health functions through methods such as early warning surveillance, and vaccine uptake
- Requires hospitals to submit data to public health agencies for measures related to nationwide surveillance for early warning of emerging outbreaks and threats
“How Medicare pays for hospital care and evaluates quality are integral pieces of achieving and addressing gaps in health equity and strengthening our healthcare system for a more sustainable future,” CMS Administrator Chiquita Brooks-LaSure said. “With this final rule, we are further improving how we measure and evaluate data while investing in quality care for people that rely on Medicare for coverage.”
CMS also finalized other Medicare payment rules in August 2021, including for skilled nursing facilities (https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-skilled-nursing-facility-snf-prospective-payment-system-pps-final-rule-cms-1746), inpatient rehabilitation facilities (https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-inpatient-rehabilitation-facility-irf-prospective-payment-system-pps-final-rule), inpatient psychiatric facilities (https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-inpatient-psychiatric-facility-ipf-prospective-payment-system-pps-final-rule-cms), and hospice providers (https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-hospice-payment-rate-update-final-rule-cms-1754-f).
Barriers to care stem from many factors. Patients may lack access to quality care (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer), experience financial toxicity (https://www.ons.org/podcasts/episode-2-financial-toxicity-patients-cancer), and or have limited treatment options because of the pandemic (https://www.ons.org/podcasts/episode-96-covid-19-coronavirus-and-cancer-care). Learn how to advocate (https://www.ons.org/covid-19-advocacy) with ONS for patients during the pandemic, no matter their situation or diagnosis.