The Centers for Medicare and Medicaid Services (CMS) has released its final rule on the 2008 Medicare hospital inpatient prospective payment system. The changes will significantly affect how hospitals are reimbursed in order to improve the accuracy of Medicare’s inpatient hospital payments by using hospital costs rather than charges, to set rates.
Although payments to all hospitals will increase by an estimated average of 3.5 percent for FY 2008 when all provisions of the rule are taken into account (primarily as a result of the 3.3 percent market basket increase), the new regulations will redistribute revenues among medical services and profoundly affect the bottom line for many hospitals.
The reforms include significant changes to the inpatient diagnosis-related groups (DRGs) in order to account more fully for the severity of each patient’s condition. The revised DRG system will be weighted on a blend of one-third charges and two-thirds hospital cost. Other changes include important provisions to ensure that Medicare no longer pays for the additional costs of certain preventable conditions acquired in the hospital. The rule also expands the list of publicly reported quality measures and reduces Medicare’s payment when a hospital replaces a device that is supplied to the hospital at no or reduced cost.
Join Healthcare Reimbursement Monitor and the reimbursement experts from CBIZ KA Consulting Services for the audio conference, “Management Briefing: 2008 Final Medicare Inpatient Prospective Payment System Rule” that took place in September 2007.
Agenda
- Details on the continued transition from charge-based to cost-based reimbursement
- Learn about the new 745 “Medicare severity” DRGs (MS-DRGs) replacing the current 538 DRG’s
- How the Deficit Reduction Act of 2005 (DRA) will now prevent hospitals from receiving reimbursement for the additional costs of treating a patient who acquires a condition during a hospital stay
- Find out about changes in the LTC DRG Classifications
- Hear about new methodologies for calculating outlier payments and capital cost reimbursement
- Increase quality reporting requirements, 27 measures, to qualify for the full market basket update in FY 2009
- New quality measures that hospitals would need to report in calendar year (CY) 2008 in order to qualify for the full market basket update in FY 2009
- New provisions for more transparency for physician-owned facilities
- Details about changes to the Wage Index
- The changes to reimbursement for recalled medical devices
- Question and answer session
CEOs, COOs, CFOs, vice president of finance, director of reimbursement, vice president of operations, strategic and implementation consultants, operations executives, executive directors, team leaders, planners, product managers, knowledge managers, department heads, medical directors, director of managed care, director of contracting, network development and provider services directors, strategic planners, healthcare management, TPAs, network managers, physician practice management, company executives, medical management directors, PHO leadership, analysts, implementer consultants, account services and administration executives
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