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CMS Proposes Higher Inpatient Pay Rate

MedPageToday, 2012

WASHINGTON -- General acute care hospitals will see a 2.3% hike in Medicare inpatient payment rates in fiscal 2013 under a proposed rule issued by the Centers for Medicare and Medicaid Services (CMS).
That figure is a "net update" after taking inflation, productivity increases, and other factors into account, the agency noted in a .
"The rate increase, together with other policies in the proposed rule and projected utilization of inpatient services, would increase Medicare's operating payments to acute care hospitals by approximately 0.9% in fiscal year 2013."
But the same proposal that raises pay rates includes proposed methodology for reducing payments -- also beginning in fiscal 2013 -- to hospitals that have excess readmissions for MI, heart failure, and pneumonia.
And it adds two conditions to the list of hospital-acquired conditions for which treatment will not be reimbursed by Medicare: surgical site infection following placement of an implantable electronic cardiac device and iatrogenic pneumothorax with venous catheterization.
The proposed rule also implements part of the Hospital Value-Based Purchasing Program -- a piece of the Affordable Care Act -- to try to improve the quality and efficiency of hospital care.
Specifically, CMS is adding a measurement for Medicare spending per beneficiary, which will look at all payments Medicare makes under the Part A and Part B program for a hospitalized beneficiary, starting from 3 days before admission and going through 30 days post-discharge.
In a separate proposal, CMS announced a payment rule for long-term care hospitals (LTCHs) -- facilities such as nursing homes and rehabilitation units that provide healthcare to patients with multiple health problems who stay longer than 25 days.
CMS also proposed five new quality measures to be assessed for LTCHs, including: Percent of nursing home residents assessed and appropriately given the seasonal flu vaccine Percent of residents assessed and appropriately given the pneumococcal vaccine Flu vaccine coverage among staff Interventions to improve ventilator care Restraint rate per 1,000 patient-days
The American College of Physicians has announced a to "help patients understand the benefits, harms, and costs" of a variety of tests and treatments.
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