New CMS Healthcare Finance Rules for Fiscal 2008
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
The Centers for Medicare & Medicaid Services (CMS) just released the final Inpatient Prospective Payment System [IPPS] rules for fiscal year 2008. The lengthy official version was published in the Federal Register on August 22, 2007.
The good news is that overall Medicare payments to hospitals should increase by an average of 3.5%. The bad news is a plethora of additional compliance regulations.
A Brief Review
And so, since it has been said that brevity is the surest route to perusal, the most important of these new payment and policy provisions include:
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A 3.3% market basket increase
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Additional hospital quality measure reporting requirements in 2008 in order to qualify for the full market basket update in FY 2009
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Final implementation of phase-in changes begun in FY 2007 to base DRG relative weights on estimated hospital costs rather than hospital charges
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A high cost outlier threshold of $22,650, down from $24,485 in FY 2007
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The launch of 745 new Medicare-Severity DRGs (MS-DRGs) which replace the current 538 DRGs over a two-year period; and “behavioral-offsets” reduce payments by 1.2% to account for expected coding change practices
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Require hospitals to report on eight preventable admission conditions that would not be paid at a higher rate unless present on admission in 2009
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New ownership disclosure requirements for physician-owned specialty hospitals (Stark III)
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New hospital disclosures requirements on how to handle emergency medical situations when no physician is present.
Enter the MS-DRGs
Perhaps the biggest changes relate to the revisions of certain long-term care hospital policies, including the transition to the MS-DRG system over two years, refinements to the relative weights for the DRGs, and application of a budget neutrality factor to the annual rate update (but not the “behavioral- offset” that will apply to acute hospital payments).
Assessment
Therefore, let all related information in our two-volume print subscription publication Healthcare Organizations: [Financial Management Strategies] guide your leadership decisions with alacrity.
Conclusion
How will the above new rules and regulations affect you and/or your healthcare institution? Your cogent thoughts, and informed opinions, are always appreciated.
Speaker: If you need a moderator or a speaker for an upcoming event, Dr. David Edward Marcinko; MBA – Editor and Publisher-in-Chief – is available for speaking engagements.
Contact him at: MarcinkoAdvisors@msn.com
Bio: http://www.stpub.com/pubs/authors/MARCINKO.htm
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