{"id":22311,"date":"2022-10-25T09:32:17","date_gmt":"2022-10-25T13:32:17","guid":{"rendered":"https:\/\/healthit-gov.go-vip.net\/buzz-blog\/?p=22311"},"modified":"2026-01-17T21:36:08","modified_gmt":"2026-01-17T21:36:08","slug":"interoperability-in-action-onc-informs-cms-ruling-on-hospital-measures-for-public-health-and-health-equity-reporting","status":"publish","type":"post","link":"https:\/\/healthit.gov\/blog\/insights-updates\/interoperability-in-action-onc-informs-cms-ruling-on-hospital-measures-for-public-health-and-health-equity-reporting\/","title":{"rendered":"Interoperability in Action: ONC Informs CMS Ruling on Hospital Measures for Public Health and Health Equity Reporting"},"content":{"rendered":"\n<p><span data-contrast=\"auto\">This is the second blog post in a <a href=\"https:\/\/healthit.gov\/buzz-blog\/category\/blog-series-cms-ipps-rule\">two-part series<\/a> that examines how policies finalized by the Centers for Medicare &amp; Medicaid Services (CMS) in the <\/span><a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/fy-2023-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective\"><span data-contrast=\"none\">2023 Inpatient Prospective Payment System (IPPS) final rule<\/span><\/a><span data-contrast=\"auto\"> are advancing the use of interoperable health IT. <\/span><a href=\"https:\/\/healthit.gov\/buzz-blog\/blog-series-cms-ipps-rule\/interoperability-in-action-cms-rule-builds-on-onc-initiatives-to-simplify-health-information-exchange\"><span data-contrast=\"none\">Previously<\/span><\/a><span data-contrast=\"auto\">, we looked at a new measure under CMS\u2019s Promoting Interoperability Program that rewards hospitals for exchanging information under the Trusted Exchange Framework and Common Agreement, or TEFCA.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">ONC works closely with CMS on the Promoting Interoperability Program to ensure certified health IT and other initiatives support the program\u2019s objectives for eligible hospitals and critical access hospitals. In this blog post, we examine an additional update to the Promoting Interoperability Program that reflects collaboration between CMS, ONC, and the Centers for Disease Control and Prevention (CDC). We also look at new policy in the Inpatient Quality Reporting program aimed at advancing health equity.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-expanding-and-incentivizing-public-health-reporting-nbsp-nbsp\"><span data-contrast=\"none\">Expanding and Incentivizing Public Health Reporting&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:0,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/h2>\n\n\n\n<p><span data-contrast=\"auto\">The Promoting Interoperability Program has been an important mechanism for driving improvement in public health reporting through the program\u2019s Public Health and Clinical Data Exchange Objective. By including measures that require hospitals to use certified health IT to capture and share public health data (e.g., immunization reporting, syndromic surveillance, reportable lab tests and results, case reporting) the program supports nationwide early warning of emerging outbreaks and threats, faster public health response, and greater visibility into immunization uptake which, in turn, can inform tailored vaccine distribution strategies.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">The 2023 IPPS rule expands the list of required public health measures under the Promoting Interoperability Program to include antimicrobial use and resistance (AUR) surveillance. Beginning in 2024, to earn full credit under the Public Health Objective, hospitals must report AUR data to CDC\u2019s <\/span><a href=\"https:\/\/www.cdc.gov\/nhsn\/index.html\"><span data-contrast=\"none\">National Healthcare Safety Network<\/span><\/a><span data-contrast=\"auto\"> (NHSN). In order to complete this reporting, hospitals must use health IT certified under ONC\u2019s certification program to the \u201cTransmission to public health agencies \u2014 <\/span><span data-contrast=\"auto\">antimicrobial use and resistance reporting<\/span><span data-contrast=\"auto\">\u201d certification criterion. More information about the criterion\u2019s capabilities, associated standards, and guidance for health IT developers can be found in the <\/span><a href=\"https:\/\/healthit.gov\/test-method\/transmission-to-public-health-agencies-antimicrobial-use-and-resistance-reporting\/\"><span data-contrast=\"none\">Certification Companion Guide<\/span><\/a><span data-contrast=\"auto\">.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">While this capability has been included in the ONC Health IT Certification Program since 2015 and many hospitals are already tracking AUR data, this new, dedicated, measure will help to ensure this important reporting activity is conducted at a national scale.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">For 2023, CMS has also increased the points available under the Public Health and Clinical Data Exchange Objective to strengthen participation in these vital activities. Finally, starting in 2024, CMS will require that hospitals demonstrate progress towards exchange of data in production with public health agencies, by limiting the time an eligible hospital or CAH can spend on registration or testing activities before moving to full production. These changes acknowledge advances in data modernization, widespread technical capabilities in public health agencies to receive standardized data from providers, and the critical role that public health reporting plays in responding to public health emergencies and closing <\/span><a href=\"https:\/\/healthit.gov\/buzz-blog\/health-it\/public-health-data-systems-hearing-ensuring-a-data-driven-response-to-covid-19\"><span data-contrast=\"none\">gaps and inconsistencies revealed\u2014and exacerbated\u2014by the COVID-19 pandemic<\/span><\/a><span data-contrast=\"auto\">.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-building-health-equity-into-quality-reporting-nbsp\"><span data-contrast=\"none\">Building Health Equity into Quality Reporting<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:0,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/h2>\n\n\n\n<p><span data-contrast=\"auto\">The 2023 IPPS final rule also adds new measures (voluntary for 2023 but required beginning in 2024) under the Hospital Inpatient Quality Reporting (IQR) program that address health equity. These measures are designed to build health equity into their core functions in three ways by assessing:&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">1) the degree of hospital leadership commitment to collecting and monitoring health equity performance data;&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">2) the percent of patients admitted to the hospital who are 18 years or older at time of admission and are screened for food insecurity, housing instability, transportation problems, utility help needs, and interpersonal safety; and,&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">3) by identifying the proportion of patients who screened positive on the date of hospital admission for one or more of these health-related social needs.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:720,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">Capturing information on these social determinants of health (SDOH) can help clinicians understand environmental factors\u2014such as where people live, work, learn, or play\u2014that influence a wide range of health conditions including the risk for heart disease, diabetes, obesity, and other medical conditions. These health equity measures can also reinforce ONC\u2019s work to include SDOH data in clinician systems, as well as efforts to ensure that health IT be <\/span><a href=\"https:\/\/healthit.gov\/buzz-blog\/health-it\/embracing-health-equity-by-design\"><span data-contrast=\"none\">designed with health equity in mind<\/span><\/a><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">As part of the final rule, CMS encouraged hospitals to capture this information using screening tools that record data in a standardized format in accordance with <\/span><a href=\"https:\/\/healthit.gov\/\/isa\/representing-social-determinants-health-screening-assessments\"><span data-contrast=\"none\">health IT vocabulary standards<\/span><\/a><span data-contrast=\"auto\">. By using tools that capture the social drivers of health screening results in a standardized way, hospitals can ensure this critical information is available to other providers delivering care and services to a patient, including community-based organizations that receive referrals to support individuals\u2019 social needs.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">CMS also highlighted <\/span><a href=\"https:\/\/healthit.gov\/\/isa\/sites\/isa\/files\/2021-07\/USCDI-Version-2-July-2021-Final.pdf\"><span data-contrast=\"none\">Version 2 of the United States Core Data Interoperability<\/span><\/a><span data-contrast=\"none\"> (USCDI)<\/span><span data-contrast=\"auto\">, published in July 2021, which included new data classes for SDOH Problems\/Health Concerns, SDOH Interventions, SDOH Goals, and SDOH Assessments. ONC recently published USCDI Version 3, which maintains the SDOH elements in Version 2. Under ONC\u2019s <\/span><a href=\"https:\/\/healthit.gov\/standards-version-advancement-process-svap\/\"><span data-contrast=\"none\">Standards Version Advancement Process<\/span><\/a><span data-contrast=\"auto\"> (SVAP), hospitals can work with developers of certified health IT to upgrade their certified health IT products to USCDI Version 2 to support ensure availability of standardized, interoperable information about social determinants of health captured in their systems.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<p><span data-contrast=\"auto\">In response to these new CMS requirements, a new stakeholder coalition, called <\/span><a href=\"https:\/\/www.whitehouse.gov\/briefing-room\/statements-releases\/2022\/09\/28\/fact-sheet-the-biden-harris-administration-announces-more-than-8-billion-in-new-commitments-as-part-of-call-to-action-for-white-house-conference-on-hunger-nutrition-and-health\/\"><span data-contrast=\"none\">Sync for Social Needs<\/span><\/a><span data-contrast=\"auto\">, will help to test out and demonstrate best practices for standardizing and digitizing related processes. ONC will share more about these stakeholders\u2019 implementation experiences in the coming months.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-better-health-for-all-americans-nbsp-nbsp\"><span data-contrast=\"none\">Better Health for All Americans&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:0,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/h2>\n\n\n\n<p><span data-contrast=\"auto\">The new policies in the 2023 IPPS final rule represent exciting ways that use of health IT and increased interoperability can help to advance priorities for improving health and health care for patients and consumers across the country.&nbsp; While the policies discussed in this blog series have focused on hospitals, CMS and ONC have also worked together to extend related proposals around use of TEFCA, strengthening public health reporting, and measures addressing health disparities to clinicians outside of hospitals through the <\/span><a href=\"https:\/\/www.cms.gov\/newsroom\/press-releases\/cms-proposes-physician-payment-rule-expand-access-high-quality-care\"><span data-contrast=\"none\">2023 Physician Fee Schedule proposed rule<\/span><\/a><span data-contrast=\"auto\">. ONC looks forward to continued collaboration with CMS and the CDC to make progress on shared goals for resilient public health, health equity, and better health care for all Americans.&nbsp;<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:120,&quot;335559739&quot;:120,&quot;335559740&quot;:259}\">&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This is the second blog post in a two-part series that examines how policies finalized [&hellip;]<\/p>\n","protected":false},"author":619,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_selected_menu":"","_show_breadcrumbs":"true","_blog_show_featured_image":false,"footnotes":""},"categories":[],"archived-category":[679],"featured":[],"topics":[408,425,418,414],"class_list":["post-22311","post","type-post","status-publish","format-standard","hentry","archived-category-blog-series-cms-ipps-rule","topics-care-continuum","topics-hit-policy","topics-interoperability","topics-public-health"],"acf":{"blog_authors":[{"blog_author_profiles":"198560"},{"blog_author_profiles":"193019"}],"hp_news_hide":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v24.8.1) - 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