Key points about 2019 Final Inpatient Payment Rule by CMS

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On August 2, CMS released its annual 2,593-page Inpatient Prospective Payment System final (IPPS) rule that boosts payments to acute care hospitals who report quality data and are EHR meaningful users by 1.85 percent.

With the 1.85 percent increase in Medicare operating rates and other changes to IPPS payment policies, there will be approximately $4.8 billion of Medicare expenditures on inpatient hospital services in 2019.

The final rule requires hospitals to publish a list of standard charges with yearly updated information publicly, so it can be requested by patients into a machine-readable content format. For price transparency to be improved, CMS is accepting suggestions to the agency for any price information concerns, such as surprise out-of-network billing and unexpected facility fees.

To further promote interoperability programs, CMS established a new scoring approach for 2019 and 2020. This change will assist in meeting meaningful use requirements and finalizes an EHR reporting period of a minimum of any continuous 90-day period.

Along with numerous changes on the final rule for documentation requirements, CMS made final changes on quality data collection with the removal of 18 measures from Inpatient Quality Reporting Program. These measures are no longer relevant or whose cost of data collection outweighs the value. An additional 21 redundant measures were also removed from the IQR Program, but will be retained in other programs.

In reference to patient empowerment, CMS Administrator Seema Verma has said at the 2017 Forbes Healthcare Summit, “It’s putting out more information for individuals and structuring the programs in a way that incentivize our beneficiaries to be active consumers of their healthcare.”

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