Inpatient Prospective Payment Systems (IPPS)

More than three-quarters of the nation's inpatient acute-care hospitals are paid under the inpatient prospective payment system, while nearly a quarter are paid based on costs and are called Critical Access Hospitals. The IPPS pays a flat rate based on the average charges across all hospitals for a specific diagnosis, regardless of whether that particular patient costs more or less. Everything from an aspirin to an artificial hip is included in the package price to the hospital.

CMS on Dec. 20 finalized a new payment model that will bundle payment to acute care hospitals for heart attack and cardiac bypass surgery services. This Advisory highlights the critical changes CMS made to the programs from the proposed rule.
Hospital Value-based Purchasing Program: Impact Calculator
Medicare Operating Disproportionate Share Hospital Payments: Impact Calculator
We are pleased CMS reversed the effects of the 0.2 percent payment reduction that was part of the original “two-midnight” policy, and restored the resources that hospitals are lawfully due. However, we are disappointed that CMS finalized an unjustified cut to reimbursement rates for hospital…
Members-only Webinar The FY 2017 Inpatient PPS Proposed Rule: What You Need to Know Monday, May 16 at 3 p.m. ET