Final Inpatient Rule

Facilities that are considered to be acute care hospitals (ACHs) will find themselves receiving a $2.4 billion increase when it comes to payment rates in the year of 2018.

Additionally, these same facilities will find that the reporting requirements for electronic-based health records under the new inpatient payment rule from the Centers for Medicare and Medicaid Services will be much more relaxed than in recent years.

When it comes to total care and bundled payments, this seems to be highly positive news; however, the ruling does not provide very much optimism in terms of long-term care hospitals (LTCHs). The final rule projects that there will be a cut of 2.4% for the year of 2018.

Continue reading to learn more about the points of the inpatient prospective payment system (IPPS).

Effective Date

The new rule will officially take effect on the 1st of October, 2017. Currently, the American Physical Therapy Association staff members that are part of regulatory affairs are reviewing this rule. Over the course of the next few weeks, the details and highlights of the rule will be published. The pre-information derived from the rule was released on the 2nd of August, 2017. The policies of this rule and the payments associated with the rule will apply directly to patients that have a discharge from short-term and long-term hospitals from October 1st of 2017 to September 20th of 2018. Upon the effective date of this new rule, providers will experience relief from the current regulatory-based burdens. Additionally, a new support system between doctors and patients will be put into place. CMS has outlined the fact that this new rule will aid in optimizing transparency, improving flexibility, and increasing innovation in terms of the care that is delivered to patients.

Critical Highlights of the New CMS Rule

The following outlines the most important highlights of the new rule from the Centers for Medicate and Medicaid Services, as presented on the 2nd of August 2017:

  • CMS is officially backing off on the reporting requirements associated with quality measuring for those hospitals that are directly in the EHR incentive programs that are offered by Medicaid and Medicare.
  • The 2.4% reduction in payments for long-term care hospitals comes in addition to a moratorium for a period of 1 year that states that the facilities will need to admit in excess of 25% of all of their patients from acute care facilities.
  • 3 new questions directly related pain will be included in the new policy. This comes as a result of the suspension of the customer surveys on pain that were designed to fight the recent opioid epidemic occurring throughout the nation. However, these questions are not focused on pain management. Instead, they are simply a means to open lines of communication about pain being experienced.

If you have an interest in learning about this new rule and similar topics related to total care, alternate payments, and other types of relevant information, visit our blog today: