CMS Issues Final Payment Rule: Strengthens link to Quality Care

The Centers for Medicare and Medicaid Services (CMS) issued a final rule that updates fiscal year (FY) 2013 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (LTCHs), and builds on the work to slow growth in future health care costs by improving patient care.

The final rule also implements key elements of the Affordable Care Act’s hospital value-based purchasing (VBP) and hospital readmissions reduction programs. The rule advances Administration efforts to tie Medicare payments to quality health care across the delivery system, with new quality reporting measures for general acute care hospitals in FY 2015 and FY 2016.

Provisions Promoting Improved Patient Care

Among the provisions promoting improved patient care and infection control, the final rule includes a new outcome measure in the VBP program that rewards hospitals for avoiding certain kinds of life-threatening blood infections that can develop during inpatient hospital stays. This measure, the central line-associated bloodstream infection measure, supports ongoing work by CMS and other hospital safety leaders to reduce healthcare-associated infections through the Partnership for Patients initiative.

For more information on the payment and quality provisions in the final IPPS/LTCH rule, go to:

The final rule can be downloaded from the Federal Register at:

The final rule will appear in the August 31, 2012 Federal Register, and will take effect October 1, 2012.