Advance Care Planning - Now a Federal Hospital Quality Measure

In early August 2026, CMS issued a final rule adopting the Advance Care Planning Electronic Clinical Quality Measure (eCQM) starting with the CY 2028 reporting period.   

First, CMS found that both the Patient Self Determination Act and the 2016 reimbursement rules have failed to promote advance care planning. Second, CMS found that advance care planning is important for value congruent care. Third, CMS accordingly articulated the new CQM.

Basically, the numerator is all adult patients with one or more inpatient encounters who had either (1) an advance care planning document or (2) documentation of an advance care planning discussion. The denominator is all adult patients who are discharged from an inpatient hospitalization. Testing shows that hospitals in the 90% percentile have a 61% performance rate.