CMS to Mandate Malnutrition Care Score (MCS) Reporting for Hospitals Starting in 2028
Transition from Voluntary to Mandatory National Reporting
The Centers for Medicare & Medicaid Services (CMS) has finalized the mandatory reporting of the Malnutrition Care Score (MCS) in the 2027 fiscal year Inpatient Prospective Payment System (IPPS) final rule. Hospitals will begin submitting MCS data for the 2028 performance period, with the results being incorporated into the Hospital Inpatient Quality Reporting (IQR) program payment determinations for the 2030 fiscal year. This represents an escalation from a voluntary electronic Clinical Quality Measure (eCQM) developed by the Academy of Nutrition and Dietetics, which began voluntary reporting in 2024, to a core operational requirement. With the linkage to reimbursement, nutrition management becomes a compliance task for hospital leadership, impacting data quality and revenue beyond clinical recommendations.
Four-Step Nutrition Care Measured Through Electronic Health Records
The MCS comprehensively measures whether adults hospitalized for 24 hours or more have undergone malnutrition risk screening, registered dietitian (RD) assessment, diagnosis of moderate or severe malnutrition, and completion of an individualized nutrition care plan. Starting in 2026, the target population expanded from age 65 and older to age 18 and older, encompassing all adult inpatient services, including surgical, oncology, and intensive care units. This is a CMS quality reporting regulation, not related to pharmaceutical development or FDA clinical Phase assets, and is not linked to specific brand names, generics, molecular targets, or clinical Phase 1, 2, or 3 trials. Hospitals can ensure high data completeness by integrating structured fields in electronic health records, RD referrals, physician diagnoses, ICD coding, and CMS submissions into a closed-loop workflow.
Regulatory History and USD 42 Billion in Inpatient Costs
CMS adopted the Global Malnutrition Composite Score (GMCS) into the Hospital IQR in the 2023 fiscal year IPPS final rule, effective August 1, 2022, and implemented it as a voluntary eCQM starting in the 2024 reporting period. The 2026 fiscal year rule renamed it MCS and broadened the scope to include all adults, followed by this rule finalizing mandatory reporting for the 2028 performance period and payment linkage in 2030. Approximately 30-50% of adult inpatients in the United States are reported to have malnutrition or be at nutritional risk, and the annual direct medical costs associated with disease-related malnutrition exceed USD 15.5 billion. The Agency for Healthcare Research and Quality (AHRQ) estimates that hospital costs associated with malnutrition total USD 42 billion annually, highlighting the economic impact of early screening and intervention on length of stay, readmissions, mortality risk, and bed turnover.
Indirect Demand for Medical Nutrition Products and Hospital IT
Standardized care involves adjusting diets, providing oral nutritional supplements (ONS), or initiating enteral or parenteral nutrition based on an assessment by a registered dietitian and the patient's condition. Commercial products include Ensure from Abbott Laboratories (ABT) and Boost from Nestlé S.A. (NESN.SW), along with other medical nutrition products. Danone S.A. (BN.PA), Fresenius SE & Co. KGaA (FRE.DE), and B. Braun participate in the enteral and parenteral nutrition space. These products are not drugs and are not subject to generic names, molecular targets, FDA or EMA drug approvals, or advisory committee (AdComm) procedures. This rule does not require the prescription or purchase of specific products. The most direct beneficiaries are electronic health record and analytics solutions that automate MCS calculations, clinical alerts, RD referrals, and quality reporting. Long-term value will be demonstrated by actual rates of nutrition intervention and improvements in patient outcomes, rather than just reported scores.
With MCS becoming mandatory for the 2028 performance period, U.S. acute care hospitals must redesign their electronic health records, registered dietitian staffing, and diagnostic coding systems before the 2030 Medicare payment determination. Approximately 30-50% of adult inpatients have malnutrition or are at nutritional risk, and related hospital costs total USD 42 billion annually, making standardized screening and intervention a strategy to improve both clinical outcomes and cost control. In the short term, demand will increase for hospital IT and quality analytics vendors, as well as registered dietitians. Abbott Laboratories (ABT)'s Ensure and Nestlé S.A. (NESN.SW)'s Boost are indirect beneficiaries due to the potential expansion of the screened patient population. Researchers can use real-world data from patients aged 18 and older to validate the relationship between nutrition intervention and length of stay, readmissions, and mortality rates. However, MCS is not a Phase 1, 2, or 3 clinical asset or a specific product approval, so long-term investment returns will depend on the rate of treatment implementation and the magnitude of improvements in patient outcomes, rather than just compliance with reporting requirements.
Source: GlobeNewswire Biotech (rss_filter)