CMS will require hospitals to report performance on a patient malnutrition measure starting in 2028 under the Hospital Inpatient Quality Reporting Program.
The agency finalized the measure as part of its fiscal year 2027 Inpatient Prospective Payment System final rule released July 31.
Six things to know:
1. CMS initially adopted the Malnutrition Care Score electronic clinical quality measure, then known as the Global Malnutrition Composite Score, in the fiscal year 2023 IPPS final rule as a self-select option beginning with the CY 2024 reporting period.
2. Starting in 2028, all acute care hospitals must report the score for adult patients treated, and that data will factor into their Medicare payments in fiscal year 2030.
3. The measure scores four components of nutrition care: malnutrition risk screening at admission, a nutrition assessment for at-risk patients, documentation of a malnutrition diagnosis and a nutrition care plan for patients found to be malnourished. Each component is worth 1 point if documented, zero if not, and the values are summed for the score.
4. The score applies to adult inpatients with stays of 24 hours or longer. CMS expanded the cohort from patients 65 and older to all adults 18 and older in the fiscal year 2025 IPPS final rule.
5. CMS cited cost and outcomes data in finalizing the mandate. The agency said mandatory reporting aligns with broader HHS and CMS nutrition priorities and would increase available data on malnutrition screening and care.
6. The Academy of Nutrition and Dietetics, which began developing the measure in 2013, praised the decision in an Aug. 4 statement.
“This is an important milestone for patients and the healthcare system,” said Academy President Tamara Randall. “Malnutrition can prolong recovery and increase the risk of complications and hospital readmissions. Requiring the [Malnutrition Care Score] will help make identifying and addressing malnutrition a consistent part of high-quality hospital care.”
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