On April 18, the Centers for Medicare & Medicaid Services (CMS) released the proposed 2023 Medicare Inpatient Prospective Payment System regulation, which outlined goals to improve health equity in health care. In the proposed regulation, the CMS asked for stakeholder input on social determinants of health, including the impact of new diagnostic codes and improvements in health data collection. The CAP has supported legislative efforts to understand the social determinants that drive health care disparities in the United States and will provide recommendations for the final 2023 regulation.

In the proposed regulation, the CMS asked for specific information on how including diagnosis codes on hospital patients’ social determinants of health on Medicare claims could improve equity. The CMS wants to understand the impact of diagnosis codes on social determinants of health, which could better understand the severity or complexity of certain issues, such as housing and access to food.

The CMS also asked for input to improve its current data collection and analysis to understand disparities better. The agency asked for stakeholder input on improved data stratification and data measurement, including which measures of disparity should be prioritized and used for data reporting.

Other items in the proposed 2023 Inpatient Hospital Regulation include:

• Payment adjustment for domestically sourced supplies. The CMS is considering adding a payment adjustment for hospitals that source their N95 respirators from domestic manufacturers.
• Hospital inpatient quality-reporting program. The CMS is seeking to add 10 new measures, including one that assesses a hospital's commitment to equity, one on opioid-related adverse events and one that captures screening of social determinants of health.
• Hospital readmissions reduction program. The CMS proposed to resume the measure that tracks and penalizes hospitals for 30-day readmissions after pneumonia hospitalization beginning in fiscal 2024.

The CAP is reviewing the proposed 2023 regulation and will provide feedback by June 17.