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2021 IPPS
PROPOSED
RULE
Proposed changes to the
Inpatient Quality Reporting
(IQR) program.
CMS proposes to progressively increase the number
of quarters of eCQM data required to be
reported (over a 3-year period).
eCQM SUBMISSION
2020
1 quarter of
eCQM data
2021 2022 2023
& beyond
1
2020
1 quarter of
eCQM data
2021
2 quarters of
eCQM data
2022 2023
& beyond
1 2
2020
1 quarter of
eCQM data
2021
2 quarters of
eCQM data
2022
3 quarters of
eCQM data
2023
& beyond
1 2 3
2020
1 quarter of
eCQM data
2021
2 quarters of
eCQM data
2022
3 quarters of
eCQM data
2023
& beyond
4 quarters of
eCQM data
1 2 3 4
eCQM SUBMISSION
Hospitals must still submit
only four eCQMs.
OPIOID MEASURE
But by 2022, CMS proposes
that hospitals must submit the
Safe Use of Opioids eCQMs – Concurrent Prescribing
as one of their four eCQMs.
2020 2021 2022
Any 4
self-selected
eCQMs
2020 2021 2022
Any 4
self-selected
eCQMs
Any 4
self-selected
eCQMs
2020 2021 2022
Any 3
self-selected eCQMs
AND
Safe Use of Opioids
eCQM
Any 4
self-selected
eCQMs
Any 4
self-selected
eCQMs
Remember that the Opioid measure is available
for submission in 2021 and required in 2022 so
start improving this measure now because your
performance will be publicly reported.
P.S. Medisolv is already working with our clients on improving this measure in 2020!
OPIOID MEASURE
Did you catch that?
We said
publicly reported eCQMs.
FOR THE FIRST TIME
2021 eCQM performance for the IQR and
Promoting Interoperability programs will be
reported publicly on Hospital Compare.
FOR THE FIRST TIME
PI PROGRAM
The Promoting Interoperability program will
follow suit and increase the required number
of quarters of eCQM data submission
to match the IQR program.
(eCQMs)
HYBRID MEASURE
A reminder that the Hybrid Hospital-Wide
Readmission measure will be replacing the
READM-30-HWR claims measure starting
with a voluntary reporting period in 2021.
To submit this measure, your EHR technology
must be certified to the 2015 Edition.
AUDITS
CMS is merging the chart-abstracted
and eCQM audit process into one audit review for
both measure types. So by 2022, 400 hospitals
will be chosen for an audit of both eCQMs and
chart-abstracted measures.
Measures Submitted
Required Quarters of
Data Validation
Chart-abstracted measures
3Q 2020
4Q 2020
eCQMs 1Q 2020 – 4Q 2020
2021 Audit Schedule
Measures Submitted
Required Quarters of
Data Validation
Chart-abstracted measures
1Q 2021
2Q 2021
3Q 2021
4Q 2021
eCQMs 1Q 2021 – 4Q 2021
2022 Audit Schedule
AUDITS
One final note about audits.
CMS proposed electronic file submission only
for next year. This means hospitals would not be
allowed to send paper copies, CDs, DVDs or
flash drives of medical records.
© 2020 Medisolv, Inc. All rights reserved.
www.medisolv.com | info@medisolv.com | (844) 633-4765

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2021CMS IPPS Proposed Rule

  • 2. Proposed changes to the Inpatient Quality Reporting (IQR) program.
  • 3. CMS proposes to progressively increase the number of quarters of eCQM data required to be reported (over a 3-year period). eCQM SUBMISSION
  • 4. 2020 1 quarter of eCQM data 2021 2022 2023 & beyond 1
  • 5. 2020 1 quarter of eCQM data 2021 2 quarters of eCQM data 2022 2023 & beyond 1 2
  • 6. 2020 1 quarter of eCQM data 2021 2 quarters of eCQM data 2022 3 quarters of eCQM data 2023 & beyond 1 2 3
  • 7. 2020 1 quarter of eCQM data 2021 2 quarters of eCQM data 2022 3 quarters of eCQM data 2023 & beyond 4 quarters of eCQM data 1 2 3 4
  • 8. eCQM SUBMISSION Hospitals must still submit only four eCQMs.
  • 9. OPIOID MEASURE But by 2022, CMS proposes that hospitals must submit the Safe Use of Opioids eCQMs – Concurrent Prescribing as one of their four eCQMs.
  • 10. 2020 2021 2022 Any 4 self-selected eCQMs
  • 11. 2020 2021 2022 Any 4 self-selected eCQMs Any 4 self-selected eCQMs
  • 12. 2020 2021 2022 Any 3 self-selected eCQMs AND Safe Use of Opioids eCQM Any 4 self-selected eCQMs Any 4 self-selected eCQMs
  • 13. Remember that the Opioid measure is available for submission in 2021 and required in 2022 so start improving this measure now because your performance will be publicly reported. P.S. Medisolv is already working with our clients on improving this measure in 2020! OPIOID MEASURE
  • 14. Did you catch that? We said publicly reported eCQMs.
  • 16. 2021 eCQM performance for the IQR and Promoting Interoperability programs will be reported publicly on Hospital Compare. FOR THE FIRST TIME
  • 17. PI PROGRAM The Promoting Interoperability program will follow suit and increase the required number of quarters of eCQM data submission to match the IQR program. (eCQMs)
  • 18. HYBRID MEASURE A reminder that the Hybrid Hospital-Wide Readmission measure will be replacing the READM-30-HWR claims measure starting with a voluntary reporting period in 2021. To submit this measure, your EHR technology must be certified to the 2015 Edition.
  • 19. AUDITS CMS is merging the chart-abstracted and eCQM audit process into one audit review for both measure types. So by 2022, 400 hospitals will be chosen for an audit of both eCQMs and chart-abstracted measures.
  • 20. Measures Submitted Required Quarters of Data Validation Chart-abstracted measures 3Q 2020 4Q 2020 eCQMs 1Q 2020 – 4Q 2020 2021 Audit Schedule
  • 21. Measures Submitted Required Quarters of Data Validation Chart-abstracted measures 1Q 2021 2Q 2021 3Q 2021 4Q 2021 eCQMs 1Q 2021 – 4Q 2021 2022 Audit Schedule
  • 22. AUDITS One final note about audits. CMS proposed electronic file submission only for next year. This means hospitals would not be allowed to send paper copies, CDs, DVDs or flash drives of medical records.
  • 23. © 2020 Medisolv, Inc. All rights reserved. www.medisolv.com | info@medisolv.com | (844) 633-4765