The focus of Medicare's hospital Inpatient Prospective Payment System proposal is on quality measures such as hospital-acquired conditions, readmissions, and value-based purchasing.
The Centers for Medicare & Medicaid Services Wednesday afternoon released the 2015 proposed rules for Medicare’s hospital Inpatient Prospective Payment System.
The 1688-page document does not contain changes to the so-called "two-midnight rule" which is the subject of a lawsuit brought against CMS by the American Hospital Association and four regional associations and four healthcare organizations.
2015 IPPS Proposed Rules Detailed
The federal agency is, however, asking for input on an alternative payment methodology for short stay inpatient cases that also may be treated on an outpatient basis, and feedback on how to define a short stay.
The focus of the proposal is on quality measures such as hospital-acquired conditions, readmissions, and value-based purchasing. Specifically, CMS is proposing to reduce payments for hospitals with the highest rate of HACs by 1% to comply with the Patient Protection and Affordable Care Act. The reduction will apply to the bottom 25% of hospitals (those with the worst HAC rates).
In addition, CMS proposes increasing the maximum payment reduction for hospital readmissions from 2% to 3%. It proposes that hospitals’ readmissions penalties be assessed using five readmissions measures endorsed by the National Quality Forum.
Comments will be open through June 30. The rule will be finalized August 1. Once finalized, the IPPS rules will apply to the federal fiscal year that begins October 1, 2015. Last year, the federal Centers for Medicare & Medicaid Services published the final rules in August.
FACTSHEET: 2015 IPPS Proposal
DOCUMENT: 2015 IPPS Proposal [PDF]
Michelle A. Leppert, CPC, contributed to this report.