Rob Lazerow on August 2, 2012 |
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Topics: Medicare, Reimbursement, Finance, Market Trends, Strategy, Accountable Care, Payer and Regulatory Policy, Pay-for-Performance
Learn about the Inpatient Prospective Payment System (IPPS) final rule for 2013, which increases hospital reimbursement rates by 2.3% and finalizes important details about upcoming Medicare pay-for-performance programs.
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released the inpatient prospective payment system (IPPS) final rule for FY 2013, solidifying acute care hospital and long-term care hospital payment policies for the coming year. In addition to the highlights of the rule outlined below and in the Daily Briefing, please register for a special member webconference on Thursday, Aug. 23 at 1 p.m. ET. We'll provide our in-depth analysis of the final rule.
Final rule in brief
Overall, the final rule increases hospital reimbursement rates by 2.3%, a substantial increase from the payment update CMS initially proposed in late April. Under the proposed rule, CMS had planned to increase hospital rates by just 0.9%. After increasing the payment update, the final rule is expected to increase total inpatient hospital payments by $2 billion from FY 2012 to FY 2013.
CMS also finalized key details for two upcoming Medicare pay-for-performance programs. Specific to the Value-Based Purchasing Program, CMS finalized operational details for 2013 and the new measures that will be implemented in 2015 and 2016. Next, for the Hospital Readmissions Reduction Program, CMS finalized the readmission adjustment factor and estimated that the readmission penalties will reduce hospital payments by 0.3%, or approximately $270 million, across FY 2013.
Our analysis of the IPPS proposed rule, “Exploring the Future of Medicare Pay-for-Performance Programs,” highlighted five key implications of the new Medicare pay-for-performance programs. These five implications fully apply to the final rule:
- Contingent payment further solidified as the new norm for Medicare FFS payment
- Substantial dollars at-risk for FY2013—and the stakes increase each year
- Scope of the new performance standard broadened with additional measures
- Accountability expanding beyond hospital-level measures to system-level measures
- Medicare’s use of performance risk models gives commercial payers cover to follow suit
Register for our special webconference
Register today to join us for a webconference offering in-depth analysis the IPPS final rule on Thursday Aug. 23 at 1 p.m. ET. We will examine CMS’s finalized changes for the coming fiscal year, covering standard updates to payment structure, payment amounts, and the broader implications of these changes.
The presentation will also review the latest updates from CMS’s key quality programs, including the Hospital Value-Based Purchasing Program and Hospital Readmissions Reduction Program, and will highlight a suite of customized analytical tools designed to help members assess the impact of several policy updates contained in the final rule.
As always, if there is anything else we can do to be of assistance, please feel free to call or email me directly.
