Medicare’s Maternal Morbidity Structural Measure
The Hospital Inpatient Quality Reporting (IQR) Program is a pay-for-reporting program for acute care hospitals. Learn more about the program's Maternal Morbidity Structural Measure and what it means for publicly reported data.
The Medicare Hospital IQR Program’s Maternal Morbidity Structural Measure
The Medicare Hospital Inpatient Quality Reporting (IQR) Programs’ Maternal Morbidity Structural Measure started data collection on October 1, 2021.
In the FY 2022 Inpatient Prospective Payment System Final Rule released in August 2021, the Centers for Medicare and Medicaid Services finalized the inclusion of the new Maternal Morbidity Structural Measure in the Hospital IQR Program in the hopes of addressing the continuing maternal health crisis and bolster quality of care during and after labor and delivery.
This measure...
- Determines the number of hospitals currently participating in a structured state or national Perinatal Quality Collaborative (PQC)
- Determines whether hospitals are implementing the safety practices or bundles included as part of these QI initiatives
Programs that have implemented these safety practices or bundles have shown to be effective in decreasing maternal morbidity and the quality of obstetric care delivery. ACOG supports the inclusion of this new measure in the Hospital IQR Program and aims to provide the educational resources needed to ease the transition of providers and hospitals in reporting this new measure.
Hospitals participating in the Hospital IQR Program must report the measure during CMS specified time period. Full reporting on this measure began in 2022 with payment determinations affecting the 2024 year. Details on the measure specifications can be found in the educational resources below.
Why Is this Measure Important?
Maternal morbidity and mortality are long-standing issues that continue to impact pregnant women and individuals across the country. This even further exposes health inequities faced by women of color, as Black women are three times more likely to die from pregnancy-related complications than non-Hispanic White women. Finding ways to tackle this issue is a prime focus of ACOG advocacy and policy initiatives. ACOG believes PQCs are an important tool in the arsenal in fighting maternal morbidity and mortality.
How Can My Hospital Report this Measure?
This measure is reported through the CMS-approved web-based data collection tool available on the QualityNet website, similar to other measure reporting methods. Given the structure of the measure, answers will vary from yes, no, or N/A on whether a hospital is participating in a PQC and have implemented patient safety practices or bundles.
How Is this Measure Used?
This measure is used by publicly reporting results on the CMS Care Compare website. This tool is used to find and compare different Medicare providers, including hospitals, in a given area. Hospitals reporting that they are actively participating in a PQC and implementing a patient safety bundle as outlined in this measure are designated a “Birthing-Friendly” hospital and represented as such on the Care Compare website.
Perinatal Quality Collaboratives
PQCs are aimed at improving maternal outcomes through the implementation of patient safety bundles addressing pregnancy complications including hemorrhage, severe hypertension/preeclampsia or sepsis. These patient safety bundles can be utilized through the Alliance for Innovation on Maternal Health (AIM), a national program that leads in the development and implementation of best practices to promote safe care for every birth. AIM provides support to many state-based teams, including PQCs, to aid in the implementation of its bundles.
How Can My Hospital Get Involved in Statewide or National PQCs or AIM?
Many states have active collaboratives and others are currently in development. The Centers for Disease Control and Prevention (CDC) maintains an interactive list of PQCs in the United States. Hospitals interested in engaging with their state PQC should contact the coordinating entity directly.
PQCs are coordinating the efforts of the Alliance for Innovation on Maternal Health (AIM) program in many states. Access an interactive list of states currently enrolled in the AIM program. Hospitals interested in participating in the AIM program should contact [email protected] to be connected with their state contact. State contacts exist for all states, regardless of AIM enrollment status.