News & Analysis

October 1, 2016
HIM Briefings

The fiscal year (FY) 2017 IPPS final rule was released August 2 and will be published in the Federal Register August 22. The majority of the finalized updates are consistent with those outlined in the proposed rule, but with a few refinements to applicable time periods. The final rule expands and refines the number of claims-based ­outcomes linked to payment under these programs.

Effective October 1, 2017, performance for cost and quality measures in the HRRP, HVBP, and HACRP will impact up to 6% of your hospital's inpatient acute Medicare fee-for-service reimbursement.

So, where to begin? First, become familiar with the measure specifications and risk-adjustment methodologies, in addition to existing CMS provided reports on historical performance, to gain insights into your organization's clinical documentation and coding vulnerabilities.

Measure specifications can be found at:

The final rule is available here:

September 28, 2016
Medicare Insider

This week’s note from the instructor is about changes resulting from the hospital readmission reduction program.

September 27, 2016
Medicare Web

I heard the 2-midnight rule is now gone based on changes to Medicare payment rates under the 2017 inpatient prospective payment system final rule. Is this true and if not what changed?

September 6, 2016
Medicare Web

Is there any reason why an inpatient-only procedure would be performed on an outpatient?

August 23, 2016
Medicare Web

Now that CMS has released a new version of the Medicare Outpatient Observation Notice how should my organization proceed?

August 16, 2016
Medicare Web

Hospitals got a last-minute reprieve from the Medicare Outpatient Observation Notice (MOON) notification requirement, which was set to go into effect August 6. Citing the need for additional time to revise the standardized notification form that hospitals will need to use to notify patients about the financial implications of being assigned to observation services, CMS moved back the start date for the requirement in the 2017 IPPS final rule to “no later than 90 days,” after the final version of the form is approved.