Hospitals that adhere to quality reporting rules and meaningful use of electronic health records will receive a 2.8% net increase in Medicare reimbursements in fiscal 2024 under the regulations. A proposed rule for a future inpatient hospital billing system released Monday by the Centers for Medicare and Medicaid Services.
The hospital inpatient rate for the next financial year is the result of a 3% increase in the market basket minus a 0.2 percentage point decrease based on expected productivity improvements. Facilities penalized for excessive readmissions or hospital-acquired conditions will receive lower reimbursements, while those participating in the value-based purchasing program will see their rates discounted. Adjusts up or down based on performance.
Under the proposed rule, CMS would maintain a low-wage hospital policy that limits the wage reduction index to 5%. CMS is using FY 2019 data to calculate FY2024 salary metrics until more data becomes available.
Hospital groups objected that CMS’s proposals were impractical given the challenging economic environment.
“The [American Hospital Association] deeply concerned about CMS’s proposed inadequate inpatient hospital billing update of 2.8% due to near-decade high inflation and rising costs of labor, equipment, drugs, and supplies. Furthermore, long-term care hospitals will see a staggering negative 2.5% billing update under this proposal. Ashley Thompson, senior vice president of public policy analysis and development, said in a press release.
“This IPPS-recommended inflation payment update is disappointing,” Federation of American Hospitals President and CEO Chip Kahn said in a press release. “They don’t realize today’s headwinds will strain the medical safety net by 2024, which will further threaten patients’ access to care as hospitals are forced to cut back. services or in some cases, especially in rural areas, to close completely.”
Likewise, America’s Essential Hospitals said they were concerned about the 2.8% payout ratio as well as the proposed cut of more than $200 million in Medicare disproportionate shared hospital payments. . “Ongoing pressures, such as inflation and high labor and supply costs, require stronger investment by Medicare, an important source of support for essential hospitals and the communities in which they operate. serve,” Beth Feldpush, the group’s senior vice president of policy and advocacy, said in a press release.
Safe and fair
The draft regulation also seeks to strengthen CMS’s efforts to address patient health equity and safety through the payment system. “This proposed rule reflects our people-centred approach to better measure healthcare quality and hospital safety in order to reduce preventable harm, and Our commitment is to ensure that rural and disadvantaged people with Medicare have improved access to high-quality health care,” CMS Administrator Chiquita Brooks-LaSure said in a statement. a press release.
CMS proposes three new quality reporting measures: pressure trauma; acute kidney injury; and exposure to excessive radiation. The agency also intends to revise three quality measures: the combined all-cause risk standardized mortality; hospital-wide re-hospitalization for any cause; and COVID-19 vaccinations for healthcare workers. And CMS proposes to eliminate three measures: hospital-grade risk-standardized complication rates after elective initial total hip replacement surgery and/or total knee replacement; Medicare spending per beneficiary; and elective delivery before the completion of 39 weeks of pregnancy.
The proposed rule for a potential inpatient payment system for fiscal year 2024 also seeks to advance CMS’s health equity agenda. The agency proposed 15 additional equity-related measures for data collection. The draft regulation would also increase severe measures for homelessness as a complication or comorbidity.
Long-term care hospital
The same draft regulation includes proposed future payment system updates for long-term care hospitals. The standard payment will increase by 2.9% in fiscal year 2024, while the compound payment will decrease by 0.9%.
Alex Kacik and Lauren Berryman contributed to this story.
