AHA Statement on Inpatient Final Rule
Based on an initial review, today’s rule appears to recognize the concerns of America’s hospitals and contains modifications intended to ensure a smoother implementation of the new inpatient payment system.
While we continue to have concerns about the rule’s impact, the Centers for Medicare & Medicaid Services has listened to the hospital field’s views and made important changes from its proposal. The agency modified the new DRG payment weights and provided a much-needed three-year transition. During this time, the agency has pledged to work in an open and constructive way to address changes moving forward. In the meantime, they have corrected some significant flaws the AHA pointed out that would have an adverse effect on many hospitals.
Also, CMS did not yet adopt the patient classification system, which would have represented the biggest change in hospital inpatient payment -- without proven benefit. CMS has indicated a process to determine the appropriateness in moving ahead and we look forward to being part of that process. In the new rule, hospitals submitting data on an additional 12 quality measures starting this July -- instead of January -- will receive a full update. This will allow the overwhelming majority of hospitals that have willingly shared quality data time to work with their contractors to continue to do so.
This is a significant regulation and we will review the details in the coming days. While we continue to believe a one-year delay is needed given the rule’s complexity, we are committed to working with CMS to ensure any needed changes are addressed in future years.
Ultimately, with more than 40 percent of hospitals being reimbursed less than the cost of delivering services to Medicare inpatients, it’s essential to build a more equitable and accurate payment system that allows hospitals to continue to serve their communities.
About the AHA
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.
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