Course | Basic | Medicare Payment and Reimbursement
In this course we will address scheduling processes, including<div><ul><li>Patient identification</li><li>Requested service</li><li>Medical necessity screening</li><li>Medicare Advance Beneficiary Notice of Noncoverage processing</li><li>Pa...
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Course | Overview | Medicare Payment and Reimbursement
This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recen...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Pro...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective paym...
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On Demand Webinar | Intermediate | Medicare Payment and Reimbursement
As the senior population continues to outpace the relative growth of the general population, and Medicare Advantage is accounting for about one-third (and growing every year) of all new Medicare eligible enrollees, providers are increasingl...
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Fact Sheet | Medicare Payment and Reimbursement

Hospital Inpatient Value-Based Purchasing Program Final Rule Fact Sheet

Fact Sheet | Medicare Payment and Reimbursement

Hospital Inpatient Value-Based Purchasing Program Final Rule Fact Sheet

CMS published a final rule to implement a new hospital value-based purchasing program under which hospitals that meet or exceed certain quality measures relating to clinical process of care and patient experience of care would be rewarded incenctives beginning in FY13.

The value-based purchasing (VBP) program will provide fiscal year incentive payments to PPS acute care hospitals that meet or exceed certain quality measures relating to clinical process of care and patient experience of care.

  • Hospitals will be eligible to receive these incentive payments beginning in FY13 for discharges occurring on or after October 1, 2012.
  • The performance period will include the fourth quarter of FY11 (July 1, 2011-September 30, 2011) and the first and second quarters of 2012 (October 1, 2011-March 31, 2012).
  • CMS is adopting 12 measures for the FY13 hospital VBP measure set, and eight patient experience of care measures from the HCAHPS survey.
  •  Scores for clinical process of care measures will be based on both achievement and improvement of process of care metrics, while scores for the HCAHPS patient experience of care measures will based on achievement, improvement, and consistency of the metrics.

Download the fact sheet 

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