Pay­ment-rate hike pro­posed for out­pa­tient, am­bu­la­tory cen­ters

Modern Healthcare - - LATE NEWS -

The CMS pro­posed a 2.1% pay­ment-rate in­crease to hos­pi­tal out­pa­tient de­part­ments and a 1.3% boost to am­bu­la­tory surgery cen­ters for 2013. Based on th­ese rates, the CMS ex­pects to­tal pay­ments for ser­vices to Medi­care ben­e­fi­cia­ries at hos­pi­tal out­pa­tient de­part­ments to to­tal about $48.1 bil­lion next year, while pay­ments to am­bu­la­tory surgery cen­ters should amount to about $4.10 bil­lion. Pay­ments to hos­pi­tal out­pa­tient de­part­ments are based on a for­mula that is equal to the hos­pi­tal mar­ket­bas­ket (which rep­re­sents an in­fla­tion rate of goods and ser­vices that hos­pi­tals use for in­pa­tient ser­vices) of 3% mi­nus a 0.9% ad­just­ment for pro­duc­tiv­ity. The agency also in­di­cated that it will con­tinue a 2% re­duc­tion in pay­ments for those hos­pi­tals that don’t meet hos­pi­tal out­pa­tient qual­ity re­port­ing re­quire­ments. For the ap­prox­i­mately 5,000 am­bu­la­tory surgery cen­ters that par­tic­i­pate in the Medi­care pro­gram, the CMS is propos­ing ad­di­tional re­quire­ments for the ASC qual­ity re­port­ing pro­gram that ap­ply to the re­port­ing of qual­ity data, a pol­icy for up­dat­ing mea­sures, and re­quire­ments re­lated to data com­plete­ness. The nearly 700-page pro­posed rule also sug­gests changes to the in­pa­tient re­ha­bil­i­ta­tion qual­ity re­port­ing pro­gram and changes to the qual­ity im­prove­ment or­ga­ni­za­tion pro­gram. For in­stance, QIOs would have the au­thor­ity to send and re­ceive se­cure trans­mis­sions of elec­tronic ver­sions of health in­for­ma­tion, and ben­e­fi­cia­ries could au­tho­rize the QIOs’ use and dis­clo­sure of con­fi­den­tial in­for­ma­tion.

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