These are the reflected changes in the CMS 2018 IPPS Proposed Rule.

1. CMS 2018 IPPS
Proposed Rule

2. HIGHLIGHTS FROM THE
PROPOSED CHANGES TO CMS
PROGRAMS IN 2017

3. MEANINGFUL USE PROGRAM
(PROPOSED 2017 CHANGES)
Reporting period: Submit data from any 2 self-selected quarters of 2017.
(Includes Eligible Hospitals and Critical Access Hospitals who are
demonstrating Meaningful Use for the first time or have done it before.)
Measure reporting: Select and submit 6 of the available 15 eCQMs in 2017.

4. INPATIENT QUALITY REPORTING PROGRAM
(PROPOSED 2017 CHANGES)
Reporting period: Submit data from any 2 self-selected quarters in 2017.
Measure reporting: Select and submit 6 of the available 15 eCQMs in 2017.

5. Technical Submission
Requirements:
EHR technology must be certified
to all available eCQMs.
EHR does not need to be
recertified with each eCQM
specification update.
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6. HIGHLIGHTS FROM THE
PROPOSED CHANGES TO CMS
PROGRAMS IN 2018

7. OPERATING PAYMENT RATES
(PROPOSED 2018 CHANGES)
Operating Payment Rate
1.6% increase in operating payment rates.
$3.1 billion increase in 2018.
Uncompensated Care Payments
$1 billion increase in uncompensated care payments.
Total $7 billion for 2018.
Uncompensated Care Payments
In 2018, CMS will begin incorporating uncompensated
care cost data from Worksheet S-10 in the methodology
for distributing the uncompensated care funds.

8. HOSPITAL READMISSIONS
REDUCTION PROGRAM (HRRP)
(PROPOSED 2018 CHANGES)
Implement Socioeconomic Adjustment
Assess penalties based on a hospital’s
performance relative to other hospitals with
similar proportion of patients who are dully
eligible for Medicare and Medicaid.

9. MEANINGFUL USE PROGRAM
(PROPOSED 2018 CHANGES)

10. Measure reporting: Select and submit 6 of the available eCQMs in 2018.
Submission deadline: February 28, 2019
Eligible hospitals and critical access
hospitals meaningful use requirements
Reporting period: Submit data from the first 3 quarters of 2018 (Q1, Q2, Q3).
Measure reporting: Select and submit 6 of the available eCQMs in 2018.
Submission deadline: February 28, 2019
Add a new exception for hospitals whose certified EHR technology has been
decertified by ONC.

11. Eligible Physicians
Meaningful Use Requirements
Reporting period: A minimum 90-day period during 2018
Align the available eCQMs with the eCQMs available in MIPS
No payment adjustments for those who perform “substantially all”
services in an ambulatory surgical center.

12. HOSPITAL INPATIENT QUALITY
REPORTING (IQR) PROGRAM
(PROPOSED 2018 CHANGES)
Reporting period: Submit data from the first 3 quarters of 2018 (Q1, Q2, Q3)
Measure reporting: Select and submit 6 of the available 15 eCQMs in 2018.

13. Revise two measures:
Rewording of current pain management questions
in HCAHPS survey (NQF #0166) to focus on the
hospital’s communications with patients about
the patients’ pain during the hospital stay.
Measure 1 Change
Changing the risk adjustment methodology in
Stroke 30-Day Mortality Rate measure to include
stroke severity codes (MORT-30-STK).
Measure 2 Change

14. Voluntary reporting of one new measure:
Hybrid Hospital-Wide Readmission measure with Claims and EHR data.
eCQM audit adjustment:
Reducing the number of cases required to be submitted for an audit
(8 cases / quarter = 16 cases in 2017, 24 cases in 2018).

15. Additional exclusion
criteria for audits
Exclude hospitals that do not have
at least 5 discharges for a least 1
eCQM submitted.
Exclude cases with episodes of care
longer than 120 days.
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Exclude cases with 0 denominators
for each measure.
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16. Hospital Value-Based
Purchasing (VBP) Program
(Proposed 2018 changes)

17. Revise the Efficiency and Cost Reduction domain weighting beginning in 2019.
Adopt the hospital-level, risk-standardized payment associated with a 30-Day
Episode of Care for Pneumonia measure for the Efficiency and Cost
Reduction domain beginning in 2020.
Add a measure in 2021: 10-indicator PSI 90 beginning in 2021

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