Becker's ASC Review

Becker's ASC Review September/October 2015

Issue link: https://beckershealthcare.uberflip.com/i/572638

Contents of this Issue

Navigation

Page 105 of 107

106 C MS has issued its inpatient prospective payments systems final rule for fiscal year 2016, which calls for an increase in Medi- care reimbursements to some hospitals in the next fiscal year. e 2,149-page rule also includes rates for long- term care hospitals. Overall, the rule will apply to about 3,400 acute care hospitals and 435 long- term care hospitals. Here are 10 of the most important points to know about CMS' final IPPS rule for FY 2016. Hospital payments 1. Under the final rule, acute care hospitals that report quality data and are also meaningful us- ers of EHRs will receive a 0.9 percent increase in Medicare operating rates. Hospitals that do not submit quality data would lose a quarter of the market basket update (2.4 percent), and hospitals that are not meaningful users of EHRs would lose one-half of the market basket update in FY 2016. 2. CMS arrived at its proposed rate of 0.9 percent (again, which only would apply to hospitals that report quality data and attest to meaningful use) through the following updates: a positive 2.4 percent market basket update, a negative 0.5 update for a pro- ductivity adjustment, a negative 0.2 percent update for cuts under the Affordable Care Act and a negative 0.8 percent documentation and coding adjustment as part of the American Taxpayer Relief Act of 2012. Legislators included $11 billion in MS-DRG docu- mentation and coding adjustments in that bill. is meant hospitals and other providers would lose $11 billion in Medicare payments between fiscal 2014 and fiscal 2017 due to past overpayments the government made to hospitals during the transition to MS-DRGs. Hospital-Acquired Condition Reduction program 3. Under the final rule, hospitals with the poorest performance in reducing HACs, specifically those in the lowest quartile, will have their Medicare pay docked by 1 percent. Medicare disproportionate share hospital payments 4. As part of the ACA, Medicare disproportion- ate share hospital payments will be reduced by 75 percent, or $49.9 billion, by 2019. Under the final rule, overall DSH payments will be cut by $1.2 billion in FY 2016, compared to the estimated FY 2015 amount. "e decrease is primarily at- tributable to continued declines in the number of uninsured individuals since the passage of the Af- fordable Care Act," according to CMS. Bundled Payments for Care Improvement initiative 5. In 2011, CMS launched the BPCI initiative, link- ing payments for multiple services during an epi- sode of care into a bundled payment. In the final rule, CMS thanks commenters for their feedback on policy and operational issues surrounding the potential future expansion of this initiative. Hospital Inpatient Quality Reporting program 6. Under the final rule, CMS adds seven new measures to the HIQR program. ere are three new claims- based measures and one structural measure added for the FY 2018 program and subsequent years, and there are three new claims-based measures added for the FY 2019 program and subsequent years. Hospital Value-Based Purchasing program 7. In the final rule, CMS makes changes to the Hospital Value-Based Purchasing program, which was established under the ACA. CMS is adding a care coordination measure beginning with the FY 2018 program year and a 30-day mortality mea- sure for chronic obstructive pulmonary disease beginning with the FY 2021 program year. 8. CMS is also removing two measures, effective with the FY 2018 program year. PSS-Exempt Cancer Hospital Quality Reporting Program 9. Established by the ACA, the PCHQR program collects and publishes data on an announced set of quality measures. In the final rule, CMS finalizes three new patient safety measures under the pro- gram. e three new measures are: a Clostridium dif- ficile infection outcome measure, a Hospital-Onset Methicillin-resistant Staphylococcus aureus bactere- mia outcome measure and a measure of influenza vaccination coverage among healthcare personnel. 10. e final rule will be published in the Federal Register Aug. 17. Comments on the rule are due Sept. 29, and the rule is effective Oct. 1. n ADVERTISING INDEX Note: Ad page number(s) given in parentheses AAAHC. info@aaahc.org / www.aaahc.org / (847) 853-6060 (pg. 15) Acumed. www.go.acumed.net/asc (pg. 97) ASCOA. development@ascoa.com / www.ascoa.com / (866) 982-7262 (pg. 7) ASCs Inc. jonvick@ascs-inc.com / www.ascs-inc.com / (760) 751-0250 (pgs. 10-11) ASD Management. rzasa@asdmanagement.com / www.asdmanagement.com / (626) 840-4248 (pg. 17) Banyan Healthcare. www.statkit.com/statkit750 / (888) 782-7548 (pg. 60) Blue Belt. outpatient@bluebelttech.com / www.bluebelttech.com / (763) 452-4910 (pgs. 46-49) Cardinal Health. www.cardinalhealth.com / (614) 757-5000 (pg. 4) CareCredit. www.carecredit.com / (800) 300-3046 ext. 4519 (pg. 63) Catalyst Partners. info@catalyst-partner.com / www.catalystpartners.com / (914) 266-8717 (pg. 101) Centinel Spine. cs@centinelspine.com / www.centinelspine. com / (484) 887-8810 (pg. 91) Constitution Surgery Centers. info@cscus.net / www.cscus.net / (860) 667-1815 ext. 317 (pgs. 52-55) Cygnus. sales@cygnusmedical.com / www.cygnus- medical.com / (800) 990-7489 (pg. 40) DePuy Synthes. www.depuysynthesadvantage.com (pg. 79) Diversey Care. www.sdfhc.com/contact-us / (800) 558-2332 (pg. 107) EndoChoice. fuse@endochoice.com / www.endochoice. com/fuse / (888) 682-3636 ext. 5 (pg. 37) EndoSoft. sales@endosoft.com / www.endosoft.com / (518) 831-8000 (pg. 41) eSutures. info@esutures.com / www.esutures.com / (888) 416-2409 (pg. 100) Ethicon. www.ethicon.com (pg. 84) Eveia Health Consulting and Management. info@eveia.com / www.eveia.com / (425) 657-0494 (pg. 9) Ferndale Healthcare. www.ferndalehealthcare.com / (866) 668-7482 (pg. 44) Fujifilm. www.fujifilmendoscopy.com / (800) 385-4666 (pg. 25) gMed. www.gmed.com/endoworks / (888) 577-8801 (pg. 27) Halyard. www.halyardhealth.com/digestivehealth (pg. 26) HealthCare Appraisers. info@hcfmv.com / www.healthcareappraisers.com / (561) 330-3488 (pgs. 18-21) HST Pathways. www.hstpathways.com / (800) 290-4078 (pg. 103) ImageFIRST. www.imagefirst.com / (800) 932-7472 (pg. 98) in2itive. info@in2itive.org / www.in2itive.org / (913) 344-7837 (pg. 13) Interventional Management Services. info@physiciancontrol.com / www.physiciancontrol.com / (404) 920-4950 (pg. 89) Kaye/Bassman International. gnz@kbic.com / www.kbic.com / (972) 265-5290 (pg. 99) Live Oak Bank. www.liveoakbank.com/healthcare / (910) 685-7745 or (910) 798-1215 (pg. 61) Mckesson. www.asc.mckesson.com / (866) 625-2679 (pg. 59) Medivators. www.medivators.com / (800) 444-4729 (pg. 33) Meridian Surgical Partners. www.meridiansurgicalpartners.com / (615) 301-8142 (pg. 92) National Medical Billing Services. info@nationalascbilling.com / www.nationalascbilling.com / (636) 273-6711 (pgs. 3, 86) Navicure. www.navicure.com / (877) 628-2873 (pg. 51) Olympus. www.medical.olympusamerica.com/ scopeguide / (800) 848-9024 (pg. 39) Omnicare. www.omnicare.com / (877) 901-3711 (pg. 31) One Medical Passport. info@mwtcorp.com / www.onemedical- passportcompany.com / (800) 540-7527 (pg. 67) Orthofix. www.orthofix.com / (888) 298-5700 or (800) 946-9008) (pgs. 70-73) PharMEDium. www.pharmedium.com / (800) 523-7749 (pg. 57) Pinnacle III. info@pinnacleiii.com / www.pinnacleiii.com / (877) 710-3047 (pg. 102) Practice Partners in Healthcare. www.practicepartners.org / (888) 310-1311 (pg. 94) ProVation Medical. www.provationmedical.com/md / (612) 313-1500 (pg. 29) Regent Surgical Health. jsimmons@regentsurgicalhealth.com / www.regentsurgicalhealth.com / (707) 396-0138 (pg. 5) Source Medical Solutions, Inc. www.sourcemed.net / (800) 719-1904 (pg. 43) Summit Imaging. www.summitimaging.com / (866) 578-5713 (pg. 35) Surgical Management Profes- sionals (SMP). info@smpsd.com / www.smpsd.com / (605) 444-8207 (pg. 58) Surgical Notes. sales@surgicalnotes.com / www.surgical- notes.com / (800) 459-5616 (pg. 81) TeamHealth. business_development@teamhealth.com / www.teamhealth.com / (888) 741-7925 (pg. 2) VMG Health. jessican@vmghealth.com / www.vmghealth. com / (214) 369-4888 (pg. 108) ADVERTISER CMS' Final IPPS Rule for 2016: 10 Things to Know By Ayla Ellison

Articles in this issue

Links on this page

view archives of Becker's ASC Review - Becker's ASC Review September/October 2015