Final IPPS and LTCH rule released by CMS

CMS released the fiscal year (FY) 2018 IPPS final rule August 2, updating Medicare payment and polices for patients discharged from hospitals from October 1, 2017, to September 30, 2018.

Under the new rule, acute care hospitals will see a total increase in Medicare spending on inpatient hospital payments of $2.4 billion in FY 2018. Based in part on the changes included in the final rule, overall payments to long-term care hospitals (LTCH) will decrease by $110 million, CMS said.

According to the final rule and HealthLeaders Media, the adjusted base payment rate, which is pegged at 1.2% has five elements:

• Market basket update, +2.7%
• Productivity update, -0.6%
• Removal of a one-time adjustment made in FY 2017 to compensate hospitals for implementation of the 2-midnight rule for hospital-admission status, -0.6%
• 21st Century Cures Act adjustment, +0.4588%
• Patient Protection and Affordable Care Act, -0.75%

CMS also modified the EHR reporting periods for hospitals attesting to meaningful use. These reporting periods were changed from a full year to a minimum of any continuous 90-day period during the calendar year for 2018.

CMS is also finalizing its proposals to implement updates to the Hospital Value-Based Purchasing Program. CMS is finalizing its proposals to:

• Adopt a payment measure associated with 30-day episodes of care for pneumonia patients for the efficiency and cost reduction domain beginning with the FY 2022 program year
• Update the weighting of measures in the efficiency and cost reduction domain to reflect the addition of the new condition-specific payment measures along with the overall Medicare spending per beneficiary measure beginning with the FY 2021 program year

IPPS final rule is slated for publication in the Federal Register on August 14.