Inpatient Prospective Payment Systems (IPPS)
More than three-quarters of the nation's inpatient acute-care hospitals are paid under the inpatient prospective payment system, while nearly a quarter are paid based on costs and are called Critical Access Hospitals. The IPPS pays a flat rate based on the average charges across all hospitals for a specific diagnosis, regardless of whether that particular patient costs more or less. Everything from an aspirin to an artificial hip is included in the package price to the hospital.
CMS today took several steps that would help deliver on its promise to ease regulatory barriers and allow America’s hospitals and health systems to better provide high-quality, efficient patient care. Last year, the AHA released a new analysis showing that providers spend nearly $39 billion a year…
Hospital-Acquired Conditions (HAC) Penalty Calculator FY 2017
Inpatient PPS Final Rule
(Uses HAC List Posted by CMS in Dec. 2016)
AHA has created a VBP calculator for hospital leaders to assess the impact of the VBP program on their organizations. The calculator is designed so that you enter your hospital's CMS Certification Number; the calculator will then estimate your net VBP gain or loss.
The FY 2019 and 2020 Final Rule…
AHA has created a Medicare operating DSH calculator for hospital leaders to estimate hospitals’ operating DSH payments – both the empirical portion as well as the uncompens
AHA has created a HAC penalty calculator for hospital leaders to assess the impact of the FY 2019 Hospital-Acquired Condition (HAC) Reduction Program on their organizations. The calculator is designed so that you enter your hospital's CMS Certification Number; the calculator will then…
AHA has created a readmissions penalty calculator for hospital leaders to assess the impact of the Hospital Readmissions Reduction Program on their organizations.
The Medicare Payment Advisory Commission this week discussed several draft recommendations for Congress, which it could vote on in January. The proposals would make recommendations to increase payment rates for hospital inpatient and outpatient services by 1.25% in 2019; eliminate the 2019 and 2020…
The Centers for Medicare & Medicaid Services this week is expected to release in its MLN Connects newsletter a notification requesting that hospitals review Worksheet S-10 data to ensure cost reports pass all recent edits. On Sept. 29, CMS released Transmittal 11, which modified the application…
The Centers for Medicare & Medicaid Services has extended to Jan. 2, 2018 the deadline for hospitals to amend their Medicare Cost Report Worksheet S-10s from fiscal years 2014 and 2015. The new data will not be used to calculate Medicare disproportionate share payments for FY 2018, but will be…