CMS finalizes 2019 hospital payments, scraps controversial inpatient reimbursement rule
CMS finalized a rule for inpatient and long-term care hospital payments, tossing out a controversial reimbursement plan with it.
The rule states CMS is working on a proposal to eliminate the 25-percent threshold policy, which was finalized in fiscal year 2005 and adjusted payments for long-term care hospitals when 25 percent or more of their discharges came from one hospital. The payments were projected to be significantly lower, and the policy was never implemented.
Long-term care hospitals will receive a 0.9 percent increase, or $39 million, in payments in 2019.
In addition, the agency finalized changes within its MyHealthEData initiative, which provides patients and families greater access to their electronic medical records, and is removing unnecessary, redundant and process-driven measures from several pay-for-reporting and pay-for-performance quality programs in its Meaningful Measures initiative.
CMS maintained the measures will reduce administrative burden for providers and put patients first.
“We’re excited to make these changes to ensure care will focus on the patient, not on needless paperwork,” CMS Administrator Seema Verma, MPH, said in a statement. “We’ve listened to patients and their doctors who urged us to remove the obstacles getting in the way of quality care and positive health outcomes. Today’s final rule reflects public feedback on CMS proposals issued in April, and the agency’s patient-driven priorities of improving the quality and safety of care, advancing health information exchange and usability, and removing outdated or redundant regulations on healthcare providers to make way for innovation and greater value.”
The final rule also provides a payment increase of approximately 3 percent for Inpatient Prospective Payment System (IPPS) hospitals, which pays hospitals for services provided to Medicare beneficiaries using a national base payment rate. The update impacts 3,330 acute care hospitals and approximately 420 long-term care hospitals (LTCHs), and will be effective October 1.
The rate increase, plus other changes in the IPPS payment policies, will boost spending on inpatient hospitals services by $4.8 billion in 2019, according to CMS. The increases include a new technology add-on payment of $0.2 billion.
In addition, CMS outlined price transparency goals that will require hospitals to display all standardized charges online starting in 2019. The information is also required to be updated annually. Hospitals are already required to establish and make a public list of their standard charges. CMS also stated it is considering comments it received about other barriers to price transparency and out-of-pocket costs to consumers.
See the final rule here.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."