U.S. News & World Report recently released its 2022-2023 nursing home ratings, which revealed major differences in its assessments compared with the Centers for Medicare and Medicaid’s (CMS) star rating system. The media company found that only a small portion of the nation’s 15,000 nursing homes were high performing in short- or long-term rehabilitation, and only a few hundred were high performing in both.
The Centers for Medicare & Medicaid Services (CMS) announced it is increasing scrutiny and oversight over the country’s poorest-performing nursing facilities, to immediately improve the care they deliver. A series of revisions to the Special Focus Facility (SFF) Program will toughen requirements for completion of the program and increase enforcement actions for facilities that fail to demonstrate improvement. CMS is also calling on states to consider a facility’s staffing level in determining which facilities enter the SFF Program.
The Biden administration plans to leverage the federal government’s clout as a major purchaser of health services to try to improve the quality of maternal care, with plans to create a new “Birthing-Friendly” hospital designation.
Federal officials intend to give hospitals a break in quality scoring due to pandemic strains, by halting reporting of a measure known as the PSI 90 score. Patient-safety and business groups are fighting this plan, arguing it would erode quality of care.
Journalists may find good stories in looking at this battle over a quality measurement that pits Medicare and hospitals against patient-safety and employer groups.
The American Hospital Association (AHA) and the Federation of American Hospitals supported this proposal, which was one of myriad policy changes included in Medicare’s draft fiscal year 2023 rule on payments for inpatient services. They agree with Medicare officials who said they feared the effects of the pandemic might result in distorted results that might prove unfair to hospitals that served many people at highest risk from COVID-19.
Opposition to PSI 90 proposal
Among the leaders of the opposition to the PSI 90 proposal is nonprofit Leapfrog Group. Founded in 2000 by business organizations, Leapfrog has become a major force in lobbying for greater transparency about the quality and cost of health care.
“Suppressing PSI 90 would be a giant leap backward in patient safety and transparency, literally life-threatening, and an outrageous violation of the trust Americans place in the Medicare program,” wrote Leah Binder, M.A., M.G.A., chief executive officer of Leapfrog Group, in a June 17 comment letter to the Centers for Medicare and Medicaid Services (CMS).