Issue link: https://beckershealthcare.uberflip.com/i/1120168
10 CFO / FINANCE CMS' proposed inpatient payment rule for 2020: 9 things to know By Ayla Ellison C MS released its annual Inpatient Pro- spective Payment System proposed rule April 23, which includes changes to the hospital wage index and would raise Medicare payment rates for acute care hospitals. Nine things to know: Payment rate update 1. Under the proposed rule, acute care hos- pitals that report quality data and are mean- ingful users of EHRs will receive a 3.2 percent increase in Medicare rates in fiscal year 2020, compared to fiscal 2019. 2. CMS projects the rate increase, together with changes in uncompensated care pay- ments, new technology add-on payments and other changes to inpatient payment policies, will boost total IPPS payments by 3.7 percent in fiscal 2020. Disproportionate Share Hospital pay- ments 3. CMS proposes distributing roughly $8.5 billion in DSH payments in fiscal 2020, an increase of approximately $216 million from fiscal 2019. CAR-T therapy payment update 4. Under the proposed rule, CMS would increase the maximum add-on payment for new technology, including CAR-T can- cer therapy, from 50 percent of estimated costs to 65 percent. 5. CMS said the two CAR-T therapies on the market — Gilead Sciences' Yescarta and Novartis AG's Kymriah — have price tags of $373,000. Under the proposed rule, the max- imum add-on payment would increase from $186,500 to $242,450. 6. e American Hospital Association said the payment update would help hospitals in the short term. "Based on our initial review, we are pleased that the agency has increased the new tech- nology add-on payment rate, including for CAR-T therapies," AHA Executive President Tom Nickels said in a news release. "Hospi- tals and health systems have been taking on this financial burden to ensure access to these life-saving treatments for patients, and while this proposal is not a permanent solution, it will help in the short-term." Wage index changes 7. e proposed rule includes several chang- es to the inpatient hospital wage index. Un- der the proposal, hospitals with wage index values below the 25th percentile would see an increase, while hospitals with wage index values above the 75th percentile would see a decrease. e rule would cap decreases at 5 percent for fiscal 2020. 8. CMS is proposing changes to the "rural floor" calculation, which requires the wage index values for urban hospitals to be no low- er than the wage index values for rural hospi- tals in the same state. "It appears that hospitals in a limited num- ber of states have used urban to rural hospital reclassifications to inappropriately influence the rural floor wage index value," CMS said in a fact sheet. "To address this, CMS proposes removing urban to rural hospital reclassifica- tions from the calculation of the rural floor wage index beginning in FY 2020." Comment period 9. CMS will accept comments on the pro- posed IPPS rule through June 24. n 105-year-old Ohio hospital closes By Ayla Ellison B elmont Community Hospital, a 99-bed hospital in Bellaire, Ohio, closed April 5. The hospital, which opened as Bellaire City Hospital in 1914 and was acquired by Wheeling (W.Va.) Hospital in 1996, announced plans in February to shut down. Officials cited a decline in pa- tient volume as the reason for the closure. "Utilization of BCH has continued to decline despite efforts to offer varying services at the facility," the hospital said in a press release. "The decline has place[d] a financial strain on the BCH that cannot be sustained in the long term." Wheeling Hospital offered jobs to some of Belmont Community Hospital's 93 employees. The health centers that operate under Belmont Community Hospital remain open, and long-term acute care services are available in the hospital building, according to local TV station Indiana hospital closes, lays off 269 employees By Ayla Ellison K entuckiana Medical Center in Clarksville, Ind., closed April 5. The hospital announced in late February that it would begin the process of shutting down. In March, the hospital closed its emergency room and stopped accepting ambulances. According to a Worker Adjustment and Retraining Notification Act notice filed March 4, the hospi- tal's 269 employees were laid off when the facility closed. Kentuckiana Medical Center, managed by Galichia Hospital Group, opened in 2009. n