The American Hospital Association said it was "deeply disappointed" by the proposed rule issued late Tuesday by the Centers for Medicare and Medicaid Services for fiscal 2012 that would decrease average inpatient payments to acute hospitals by about $498 million or 0.5 percent--compared with fiscal 2011. At the same time, payments to long-term care hospitals are expected to increase by 1.9 percent to about $95 million.
The proposed rule, which applies to approximately 3,400 acute-care hospitals and 420 long-term care hospitals, would be effective for discharges occurring on or after Oct. 1, 2011. It includes a hospital update of 1.5 percent and a coding adjustment of -3.15 percent to account for changes in documentation and coding following adoption of the Medicare severity diagnosis-related groups that CMS said did not reflect actual increases in patients' severity of illness.
The hospital group is concerned that CMS "continues to move forward" with the proposed coding offset, "which is excessive and wrongly assumes spending on inpatient hospital care has increased solely due to changes in coding," said AHA President and CEO Rich Umbdenstock in a statement. He also said that "independent research confirms that CMS' methodology does not recognize that hospitals are caring for patients who are older and sicker."
The proposed rule includes several quality improvement proposals promoting care quality and patient safety efforts, including the Partnership for Patients. One of the goals of the Partnership--announced by the Department of Health and Human Services last week--is to decrease preventable complications during a transition from one care setting to another.
CMS will accept public comments on the proposed rule until June 20, 2011, and will respond to them in a final rule to be issued by Aug. 1, 2011.
For more details:
- see the CMS proposed rule
- view the CMIO article
- see AHA's comments