The Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule on April 10. This rule proposes updates to payment rates for inpatient stays at acute care hospitals and requirements for various inpatient quality reporting programs. The rule also proposes changes to Medicare Severity Diagnosis-Related Groups and OR versus non-OR designations for certain surgical procedures.
Age Friendly Hospital Measure
Additionally, CMS proposes to include the Age Friendly Hospital measure in the Hospital Inpatient Quality Reporting (IQR) Program beginning with the Calendar Year (CY) 2025 reporting period. This programmatic measure, developed by the ACS in collaboration with the American College of Emergency Physicians and the Institute for Healthcare Improvement, builds on the successes of the ACS Geriatric Surgery Verification Program and incentivizes hospitals to take a holistic approach to care delivery for older adults by implementing multiple data-driven modifications to the entire clinical care pathway. The measure highlights the importance of implementing a clinical framework, using evidence-based best practices, that provides goal-centered, clinically effective care for older patients.
The Age Friendly Hospital Measure is a “focused-composite” metric that comprises a handful of structural metrics (such as staffing and roles specific to geriatrics), process metrics (such as frailty assessments and delirium screening), and outcomes focused on activities that are essential for effective care in this demographic. If finalized, the measure would be a positive step toward incentivizing team-based care organized around the geriatric patient.
Transforming Episode Accountability Model
CMS also proposed the adoption of a new mandatory episode-based payment model, the Transforming Episode Accountability Model. This model’s goal is to promote coordination between care providers during and after a surgical procedure. It initially would focus on lower extremity joint replacement, surgical hip and femur fracture treatment, spinal fusion, coronary artery bypass grafts, and major bowel procedures.
The ACS is evaluating these and other proposals to determine the impact on surgery. Contact regulatory@facs.org for more information.
