Development of Quality Measures for Inpatient Psychiatric Facilities: Final Report

As part of its National Quality Strategy, the U.S. Department of Health and Health Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the HHS Centers for Medicare and Medicaid Services (CMS) are committed to developing and implementing measures that can be used for behavioral health care quality improvement. To further the implementation of such measures, and as mandated in Section 3401, Subsection 10322 of the Patient Protection and Affordable Care Act of 2010, CMS developed the Inpatient Psychiatric Facility (IPF) Quality Reporting (IPFQR) program, a pay-for-reporting program that went into effect for fiscal year 2014. Under this program, IPFs must report their performance on a set of quality measures or face a two percentage point reduction to the update of their Medicare standard federal rate for that year. Funded through an inter-agency agreement between ASPE and CMS, the goal of this project was to develop and test measures that may be incorporated into the IPFQR program; these included four chart-based measures that assess screening for risk of suicide, risk of violence, substance use, and metabolic conditions, and one claims-based measure that assesses whether Medicare beneficiaries receive follow-up care after IPF hospitalization.