As with all decisions made by the Center for Medicare and Medicaid Services, it’s important to be aware of any changes so that you may take appropriate action. In April of this year, the CMS had proposed numerous updates and changes to their Hospital Inpatient Prospective Payment System (IPPS) and to the Long-Term Acute Care Hospital (LTCH) Prospective Payment System (PPS) for FY2018. For clarity, the difference between the PPS and IPPS system is the method of reimbursement. Where in the PPS system is based on a predetermined and fixed amount, in the IPPS system each case is categorized into a diagnosis-related group(DRG) and is assigned a payment weight based on the average resources used to treat patients in that group.
Earlier this month the CMS Final Payment Rule announced increases for both acute care and long term care hospitals, as well as hospital discharge policies. If you’re part of an acute care or long term care hospital, here are four highlights from the rule that may be noteworthy for you!
- First, the CMS Final Payment Rule will include an $800 million increase in uncompensated care payments made to acute care hospitals. This increase will bring the total for the 2018 fiscal year to approximately $6.8 billion.
- As a result of this payment increase and other policies and payment adjustments, acute care hospitals are expected to see a $2.8 billion dollar rise in Medicare spending of inpatient hospital payments in the next fiscal year.
- The same can’t be said for long-term care hospitals, they’ll instead see a decrease of $110 million.
- Last, CMS has estimated that inpatient psychiatric facilities will see a payment increase of $45 million in FY2018.
The past decade has ushered in a number of changes to regulatory, payer and accreditation standards in the healthcare industry. Mandatory healthcare compliance policies and procedures that are not only required to be in place but need to be revised, reviewed and disseminated throughout your organization. In some cases, it’s easy, in other instances when larger organizations are involved it becomes more complex.
Having good policies and procedures as well as proper management from the system level to local sites is a key component to ensuring your organization meets compliance requirements. But what more can be done in the standardization process that will support your efforts? Dignity Health discusses their approach with us, along with how they overcome challenges and set best practices that allow them to quickly respond to changes in CMS CoP guidelines–especially when they change with little notice.
Watch the on-demand webinar now for more helpful tips: