Hospitals will receive a 2.8% increase in Medicare reimbursement for outpatient care by 2024 under a proposed rule the Centers for Medicare and Medicaid Services released Thursday.
The American Hospital Association describes the increase in outpatient reimbursement as insufficient. Executive Vice President Stacey Hughes said in a press release: “Without a more robust billing update in the final rule, the ability to continue to care for patients and deliver essential services. to the hospital community and the health system could be at risk.” “Most hospitals across the country continue to operate with negative or very thin margins making it very difficult to provide care and invest in their workforce on a daily basis.”
The draft regulation also includes provisions designed to increase access to behavioral health care by creating a new benefit category called the Intensive Outpatient Program to cover medical expenses. mental health services for Medicare beneficiaries who do not need routine but less intensive care than is provided in psychiatric hospitals.
The new benefit will cover services for patients diagnosed with an acute mental illness or substance use disorder who will receive care in hospital outpatient departments, health community mental health clinics, federally qualified medical centers, and rural health clinics. The regulation also proposes an updated Medicare payment rate for partial hospitalization, an alternative to psychiatric hospitalization.
“CMS is taking action to help shape a sustainable, equitable, and high-value healthcare system,” CMS Administrator Chiquita Brooks-LaSure said in a press release.
The proposed rule would also amend CMS’s hospital price transparency initiative. CMS seeks to change standard fee display requirements and update enforcement terms. Hospitals will have to disclose standard cost data using a CMS template that also encodes standard cost information.
The draft regulation calls for a 2.8% increase in Medicare reimbursements for ambulatory surgery centers.
CMS will accept comments on the proposed rule through September 11. The final rule is expected to be available in November.
