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Aug. 5—The final inpatient prospective payment rates issued this week were slightly more than previously proposed by the Centers for Medicare & Medicaid Services (CMS).
The 1.4 percent increase in FY15 inpatient prospective payment system (IPPS) rates was a small increase over the 1.3 percent CMS proposed in April—following various cuts required by law.
Hospitals that submitted quality measure data and meaningfully use electronic health records would avoid a total 0.5 percent reduction in the 2.9 percent market-basket update. Additionally, all IPPS hospitals face a productivity cut of 0.5 percent and a 0.2 percent cut mandated by the Affordable Care Act (ACA). An additional 0.8 percent cut was required by the American Taxpayer Relief Act of 2012 to reclaim supposed overpayments stemming from FY10-FY12 documentation and coding changes.
Also included was a 1.3 percent ACA-mandated Medicare disproportionate share hospital (DSH) payment reduction. The DSH reduction was an increase over the 0.9 percent cut originally proposed.
A Bank of America-Merrill Lynch analysis, which concluded the DSH reduction was effectively 1.1 percent due to a growing pool, concluded that hospital companies would find the deeper cut “manageable.”
“However, in addition to the cut, there will be a significant change to how DSH payments will be allocated in 2014 under health care reform, which could have modestly negative implications for the publicly traded companies,” the bank analysis stated.
The deeper cut stemmed from the CMS Actuary’s decreasing estimate of payments that would otherwise be made for Medicare DSH in FY15 due to lower projected hospital inpatient spending and a reduction in the estimated population of uninsured.
Additionally, the agency indicated it will continue to work with stakeholders to address an alternative payment methodology for short inpatient stays. CMS received a range of responses to its request for comments on aspects of a new payment policy, including defining and determining appropriate costs for short stays. Although no consensus emerged among the comments, CMS officials wrote in the final rule that they would take the various views into account when crafting short-stay rule changes.
The final rule also updated the measures and financial incentives in the hospital acquired condition reduction, hospital value-based purchasing, hospital inpatient quality reporting (IQR), and hospital readmissions reduction programs. It also aligned the reporting and submission timelines for electronically reported measures in the IQR and Medicare electronic health record incentive programs.
The final rule also underscored an ACA requirement that each hospital establish and publicize a list of standard charges for items and services. CMS guidelines for implementing the provision require hospitals to publicize either a list of their standard charges or their policies for allowing public review of those charges. Although the Medicare Payment and Advisory Committee urged online posting of such prices, CMS left it to hospitals “to determine the exact manner and method by which to make the list public in accordance with the guidelines.”
The final rule also increased payments for long-term care hospitals (LTCHs) by 1.1 percent, or somewhat more than the 0.8 percent originally proposed.
Publication Date: Tuesday, August 05, 2014
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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