Small but important steps to improve the accuracy of Medicare inpatient hospital payment rates “could lead to the most important modifications since Medicare instituted the inpatient prospective payment system more than 20 years ago,” writes Paul B. Ginsburg, president of the Center for Studying Health System Change in the Nov. 16 New England Journal of Medicine. But Ginsburg cautions that there is no guarantee the Centers for Medicare and Medicaid Services “will follow through on” comprehensive changes to inpatient payment rates to better identify the severity of patients’ conditions and the resources hospitals use to care for patients, noting that “doing so will require a continued commitment to improving payment accuracy in the face of resistance from affected stakeholders.” Yet without such reforms, “providers will increasingly gravitate toward the medical problems and procedures that boost their bottom line, and the care we receive may not be the care we need,” Ginsburg concludes.
