CMS  issued proposed rules that would update the Medicare hospice payment rate and the inpatient rehabilitation facility (IRF) payment rate for fiscal year (FY) 2024, in today's bite-sized hospital and health industry news from the District of Columbia, Maryland, and New Jersey.

• District of Columbia/Geneva, Switzerland: A new report from the  World Health Organization  (WHO) found that roughly one in six people experience infertility at some point in their lives. For the report, WHO examined data from 1990 to 2021. The researchers found that 17.5% of people worldwide have been unable to have a child at some point in their lives. In the Americas, infertility prevalence was higher, with around 20% of people experiencing infertility at some point in their lives. According to WHO Director-General Tedros Adhanom Ghebreyesus, even though many people cannot have children, access to fertility treatments remains low due to "high costs, social stigma and limited availability." Pascale Allotey, WHO's director of sexual and reproductive health research, noted that the new numbers "highlight the need for infertility to be raised as a priority for universal health coverage." This report marks the first time in a decade that WHO has released a report on the prevalence of infertility, which it defined as "the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse." (González, Axios, 4/3)
• District of Columbia/New Jersey: A new  report  from the  Urban Institute (UI) and the  Robert Wood Johnson Foundation  found that inflation and increased health spending helped push monthly premiums for Affordable Care Act coverage up by an average of 3.4% between 2022 and 2023, reversing recent declines. According to the report, some of the increase can also be attributed to uncertainty over how Congress would address premium subsidies, which made it difficult for insurers to make decisions. In addition, the report found considerable variations between different regions, with consumers in smaller cities paying a steep price. John Holahan, a UI fellow, noted that inflation will likely influence 2024 rates since labor costs show no signs of decreasing. However, in inflation-adjusted terms, premiums are still decreasing, with significant pressure in competitive markets, Holahan added. (Dreher, Axios, 4/4)
• Maryland: On Friday, CMS issued a proposed rule that includes a 2.8% estimated net increase to hospice payments compared with the FY 2023 payment rate. Under the proposed rule, the payment cap per patient would be $33,396.55. With the proposed rule, CMS also published information on hospice utilization and spending trends. In addition, the agency requested comments from stakeholders on access restrictions, utilization, ownership transparency, non-hospice spending during benefit periods, the hospice election process, and health equity in the hospice benefit. Then, CMS on Monday issued a proposed rule for IRFs that would update payments by an estimated 3.7% in FY 2024. CMS also proposed an update to the IRF market basket using 2021 data, with a proposed 3.2% base payment boost minus a 0.2% productivity adjustment. (CMS fact sheet, 3/31; Lagasse, Healthcare Finance, 4/3; AHA News, 3/31; CMS fact sheet, 4/3; AHA News, 4/3; Turner, Modern Healthcare, 4/3)