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July 2014

AACR Joins Coalition in Urging CMS to Adopt Tobacco Screening and Treatment Measures

Comments consistent with commitment to reduce the toll of tobacco-related death and disease

The AACR partnered with a coalition of public health organizations to submit comments in response to the Centers for Medicare and Medicaid Services (CMS) 2015 Proposed Rule on Inpatient Prospective Payment System (IPPS). Through IPPS, CMS encourages compliance with certain health care performance measures in order to prevent cuts in CMS payments to hospitals. Consistent with AACR's commitment to reducing the toll of tobacco-related death and disease, AACR and partners encouraged CMS to amend the 2015 IPPS Rule to include tobacco performance measures developed by the Joint Commission in the quality reporting requirements for acute and long-term care hospitals and inpatient psychiatric hospitals.

Tobacco use is the leading cause of disease and premature death in the United States, and it is responsible for $150 billion in added health care costs each year. Tobacco is also a primary driver of hospitalizations for cancers, stroke, cardiovascular and respiratory diseases, and pregnancy and newborn complications. In spite of the adverse health consequences of tobacco use, most hospitals have not placed a high priority on offering evidence-based tobacco cessation assistance to patients.

Identifying and treating tobacco use is a cost effective and medically effective clinical intervention that has been demonstrated to improve health and reduce costs. Moreover, hospitalizations may be an ideal time to assist smokers to quit. CMS was, therefore, encouraged to incorporate the following Joint Commission measures into the quality reporting requirements for acute and long-term care hospitals: 1) Tobacco use screening; 2) Tobacco use treatment provided or offered during hospitalization; and 3) Tobacco use treatment management at discharge. In a separate letter, the groups commended CMS for including the first two measures in its quality reporting requirements for inpatient psychiatric facilities, and encouraged the agency to adopt the third. People with mental illness and/or substance use disorders smoke at rates two to four times higher than the overall adult population in the United States.

Read CMS's proposed rules:
Acute and Long-Term Care Hospitals
Inpatient Psychiatric Facilities