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[Slideshow] Proposed Major Changes from the 2025 IPPS Proposed Rule


The Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2025 Inpatient Prospective Payment System (IPPS). The agency placed a strong emphasis on patient safety as its top priority. CMS clearly indicated that it is moving forward at full speed with Electronic Clinical Quality Measures (eCQMs) and will require more of them for submission. Hospitals will transition from four required eCQMs in 2023 to six in 2024/2025, nine in 2026, and eleven in 2027. Woah!

In summary your major changes are:

  • Hospitals will be required to report more eCQMs, specifically related to patient safety (categorized as hospital harm eCQMs).
  • New eCQMs will be introduced in 2026 and 2027, including measures for falls with injury and post-operative respiratory failure.
  • Two new structural measures will be added, one related to patient safety and another for age-friendly hospitals.
  • Two new mandatory NHSN HAI measures will be added in 2026.
  • The HCAHPS survey will be modified with new sub-measures.
  • The Hospital Value-Based Purchasing Program will adopt a new measure for patient safety, modify the HCAHPS survey, and move up the start date for publicly displaying hospital performance on the commitment to health equity measure.
  • A new bundled payment model, the Transforming Episode Accountability Model (TEAM), will be mandatory for hospitals starting in 2026. This model will pair episode-based pricing with quality measure performance for certain procedures. Hospitals in selected geographic areas will be mandated to participate in this model and can gain or lose money based on their performance on quality measures and spending.

There were a few other changes of note which we’ve highlighted in the slideshow below.


Download these slides >>  | Download the TEAM Eligible Geographic Areas List >>

So, there you have it. Keep in mind this is just proposed changes so they may go back and change the requirements for 2025.

We know that keeping up with these yearly regulatory changes can be overwhelming. That’s why we have dedicated quality advisors who can help you better understand what each change means for your organization and ensure you have a comprehensive quality program.

Let’s conquer your quality goals together. Send us a note today.

 

Medisolv Can Help

This is a big year for Quality. Medisolv can help you along the way. Along with award-winning software you receive a Clinical Quality Advisor that helps you with all of your technical and clinical needs.

We consistently hear from our clients that the biggest differentiator between Medisolv and other vendors is the level of one-on-one support. Especially if you use an EHR vendor right now, you’ll notice a huge difference.

  • We help troubleshoot technical and clinical issues to improve your measures.
  • We keep you on track for your submission deadlines and ensure you don’t miss critical dates.
  • We help you select and set up measures that make sense based on your hospital’s situation.
  • You receive one Clinical Quality Advisor that you can call anytime with questions or concerns. 

Contact us today.

 

 

Erin Heilman

Erin Heilman is the Vice President of Marketing for Medisolv, Inc.

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