CMS' Brooks-LaSure defends 2023 pay bump for hospitals that groups charge is too small

WASHINGTON, D.C.—A 3.2% payment increase hospitals have charged is inadequate is necessary to continue to drive facilities toward more whole-person patient care, the head of the Centers for Medicare & Medicaid Services (CMS) told hospital leaders Monday. 

CMS Administrator Chiquita Brooks-LaSure took questions over the controversial payment hike proposed in the Inpatient Prospective Payment System (IPPS) rule released last week. Brooks-LaSure also gave updates on the agency’s efforts to engage with stakeholders on creating new quality measures for health equity. 

“We have statutory requirements about how we make payments in the traditional Medicare program,” Brooks-LaSure said Monday at the American Hospital Association’s (AHA's) annual meeting in Washington. “We are trying to move into a place where we continue to reward facilities and other entities that are moving to whole-person patient care.”

The AHA and other hospital groups have slammed the proposed rule’s payment update—which goes into effect in federal fiscal year 2023—as too small, especially considering inflationary cost pressures facilities are facing. 

Hospital groups also said hospitals could face negative payments alongside cuts to disproportionate share hospital payments mandated by the Affordable Care Act. They are worried about a 2% sequester cut that goes back into effect in July as well. The cut had been delayed by Congress to help providers facing financial hits due to the pandemic but will now be fully phased back in this summer.

Congress has traditionally delayed such payment cuts from taking effect, and the AHA and other groups are trying to do the same for the sequester cuts.

Brooks-LaSure said the goal of the payment bump is to try to provide payment hikes to hospitals that are “doing electronic health records, that are reporting the quality measures that we are really focused on.”

However, she called for stakeholders to deliver observations on the rule, which is open for comment until June 17.

Seeking equity engagement

Brooks-LaSure called for hospital leaders to continue to participate in requests for comment and input on how the agency will measure equity in facilities. 

The IPPS called for comments on three quality measures to be added to the Hospital Quality Reporting Program focused on equity, including measures requiring facilities to collect key data on social risk factors and demographics. 

The proposal follows similar requests for information and comments on other areas under CMS’ purview, including a request to Medicare Advantage plans on what quality measures should be added to star ratings.

“The reason why we have so many requests for information and comment is one thing we really want to bring as a leadership team is not having a top-down approach to everything,” Brooks-LaSure said. “We really want engagement, certainly from the organizations that provide care to make sure we are measuring what is valuable.”

Brooks-LaSure said the goal is to also involve safety-net providers that care for people in rural and underserved areas. 

“Health equity is not just the underserved, it’s the people and providers who serve the underserved that we need to make sure our programs work for,” she said.