AHA to MedPAC: Raise, Don't Cut Hospital Payments
"Congress directed CMS (the Centers for Medicare & Medicaid Services) to remove $11 billion in inpatient prospective payment system payments to account for alleged overpayments associated with documentation and coding changes," she wrote.
"The AHA firmly believes that no additional adjustments for documentation and coding should be considered," adding that "we disagree with MedPAC staff's assertion that changes in documentation and coding related to the move to Medicare Severity Diagnosis-Related Groups (MS-DRGs) inflated payments in FY 2010."
Fishman characterized the MedPAC recommendation on "a flawed analysis" that "additional overpayments were made in FY 2010," she wrote.
"Using this same flawed methodology, MedPAC and CMS actually maintained that real case mix was negative during the initial years following the implementation of MS-DRGs. However, numerous other indicators suggest that Medicare patients are getting sicker in ways that were not appropriately accounted for under the old DRG system. As identified in the attached TrendWatch report, rates of chronic conditions are rising."
Four out of five Medicare beneficiaries suffer from chronic diseases and two-thirds of them have two or more chronic diseases, she wrote.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
- How Top-Ranked MA Plans Earn Their Stars
- Readmissions: No Quick Fix to Costly Hospital Challenge
- How Hospitals Can Become 'Upstreamists'
- 4 Ways to Lower the Cost to Collect from Self-Pay Patients
- WellPoint Dominates Nearly Half of Markets, AMA Says
- 4 Tips for Managing Employed Physicians
- CMS Offers Some ACOs $114M for 'Upfront' Costs
- House Calls Key to Pioneer ACO Success
- Ebola: Second TX Nurse Diagnosed After Improper Protective Gear Application
- How Telehealth Pays Off for Providers, Patients