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In the most recent Medicare Program, Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) rule, CMS focuses on Glycemic Control with two new electronic clinical quality measures (eCQMs) for 2023.
CMS will add these two clinical quality measures to the list of existing options for hospitals to choose from for reporting in CY 2023, emphasizing the importance of glycemic control in patient care.
Poor glycemic control can have an adverse impact on a patient’s health, increasing the potential for complications and the overall length of stay. The measure specifications point to both hypo- and hyperglycemia rates as indicators of the quality of care provided by a facility. The discrepancies regarding glycemic control among hospitals indicate opportunities for quality improvement in this area. The inclusion of two new measures in the eCQMs encourages participating hospitals to target these opportunities.
The first of these two measures focuses on hypoglycemic events, which are among the most common adverse drug events in hospitals.
Hospital Harm—Severe Hypoglycemia identifies the proportion of patients who experience a severe hypoglycemic event, defined as blood glucose less than 40mg/dL within 24 hours of receiving an antihyperglycemic agent. According to CMS, research has shown that patients who experience a hypoglycemic event have a longer length of stay and higher medical costs than similar patients who do not experience an adverse event.
The second measure focuses on hyperglycemia, which can result in an increased risk of mortality, higher infection rates, and an increased length of stay.
Hospital Harm—Severe Hyperglycemia evaluates the number of days in which a patient experienced a severe hyperglycemic event, defined as a blood glucose reading above 300mg/dL, or a day when there was no blood glucose documented, but the preceding two days had values above 200mg/dL—for patients with a diagnosis of diabetes mellitus receiving anti-diabetic medications or admitted with an elevated blood glucose level.
While these two measures are optional and reported separately, they complement each other by simultaneously evaluating information regarding the administration of specific medications and patient blood glucose results. In both cases, a lower score indicates a higher quality of care.
In order to prepare to report on these two measures, hospitals should start reviewing their glucose management guidelines and any related orders in order sets or standing protocols.
For more on how we can help you prepare for the annual eCQM updates, contact your MEDHOST Account Executive or reach out to us at inquiries@medhost.com or call 1.800.383.6278.
