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Medicare Is Simple
Monday, June 13, 2016
CMS Proposes Rule to Improve Health Equity and Care Quality in Hospitals
The Centers for Medicare & Medicaid
Services (CMS) today proposed new standards to improve the quality of care and
advance health equity in our nation’s hospitals. The proposal applies to the
6,228 hospitals and critical access hospitals that participate in Medicare or
The rule proposes to reduce overuse
of antibiotics and implement comprehensive requirements for infection
prevention. CMS estimates that these new requirements could save hospitals up
to $284 million annually, while also improving care and potentially saving
lives. The proposed rule builds on the Department of Health and Human Services
(HHS) quality initiatives, including the National Quality Strategy, the Center for
Disease Control’s strategy to combat antibiotic-resistance
bacteria, and the Partnership for Patients.
“Working with tools provided by the
Affordable Care Act, hospitals have taken significant steps to improve safety
and quality in the past several years. Already, efforts to reduce
healthcare-associated infections have resulted in reducing health care costs by
nearly $20 billion and saving 87,000 lives,” said Kate Goodrich, M.D., M.H.S.,
Director, Center for Clinical Standards & Quality, CMS. “This proposal
further supports hospitals’ safety and quality efforts by requiring all
Medicare and Medicaid hospitals to have designated leaders in charge of
specialized programs to prevent infections, improve antibiotic use, and follow
nationally recognized guidelines.”
The proposed rule also advances
protections for traditionally underserved and often excluded populations based
on race, color, religion, national origin, sex (including gender identity),
age, disability, or sexual orientation.
“This rule marks the first time
that CMS has proposed explicitly to prohibit hospitals that accept Medicare and
Medicaid from discriminating against patients,” said Cara James, Ph.D.,
Director of the CMS Office of Minority Health. “We know that barriers still
remain in accessing quality care for communities that have been traditionally
excluded or underserved. This proposal reinforces the principle that access to
needed health services should not be blocked because of discriminatory
The proposed rule also requires
critical access hospitals, which are hospitals located in rural areas, to
implement and maintain a Quality Assessment and Performance Improvement (QAPI)
program. This program monitors and improves a hospital’s care by collecting
data to identify opportunities for improvement and develop corrective plans.
Other hospitals participating in Medicare or Medicaid already maintain these
types of programs.