CMS ‘birthing-friendly’ hospital designation will debut in 2023

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Hospitals can begin receiving a “birthing-friendly” designation from the Centers for Medicare and Medicaid Services in fall 2023, the agency announced Wednesday.

The designation will initially be based on the Hospital Inpatient Quality Reporting Program’s maternal morbidity structural measure. Hospitals will need to meet expanded criteria in the future, CMS said in a news release.

The reporting period for the morbidity measure began in October and will hospitals will submit data to CMS for the first time in May. The metric requires hospitals to attest whether they participate in a state or national perinatal quality improvement collaborative program and whether they have implemented safety practices or bundles to address birth complications such as hemorrhages and sepsis.

“Everyone deserves access to quality healthcare, especially as they start a family,” Health and Human Services Secretary Xavier Becerra said in the news release. “At HHS, we are proposing the ‘birthing-friendly’ hospital designation and working with states to provide a full year of postpartum care to ensure all parents have the best care they need—before, during and after a pregnancy.”

The American Hospital Association questioned the long-term value of the measure when CMS first proposed it last year and urged the agency to develop more robust material morbidity measures in the future.

“We believe that hospitals could make more progress—and that CMS and the public would be better informed of this progress—if CMS were to instead pursue measures that more directly assess the quality of maternal care. The proposed measure reflects participation in activities of clear benefit to hospitals and patients, but it is not really a performance measure,” the AHA wrote in a comment letter on the proposed rule.

CMS plans to publish 2021 maternal morbidity structural measure data this fall, and the first group of hospitals designated as “birthing-friendly” will be named the following fall. Additional information on the initiative will be included in the 2023 Hospital Inpatient Prospective Payment System proposed rule, which is expected in the coming weeks.

The agency maintains the “birthing-friendly” designation will help patients choose hospitals with a commitment to safe maternal health.

Maternal deaths have been increasing in the U.S. since 2000, according to a Commonwealth Fund report. Nearly 24 in 100,000 live births in the U.S. ended in a maternal death in 2020, according to data from the Centers for Disease Control and Prevention. The rate was far higher for Black women, with more than 55 in 100,000 dying during childbirth.

The announcement comes just before Black Maternal Health Week, during which Vice President Kamala Harris will host the first meeting on maternal health with Cabinet members and agency leaders.

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