In an effort to make physicians more accountable for proper documentation, CMS has been doing the transmittal shuffle as of late--and the process may have you thoroughly confused.
If the 2-midnight rule keeps you up at night, it might help to add some PEPPER to your processes. CMS recently updated PEPPER, otherwise known as the Program for Evaluating Payment Patterns Electronic Report, to provide hospitals with insight into how well they're doing with 2-midnight rule compliance.
In the accountable care organization era, controlling costs and maximizing the efficiency of care has become a priority for many organizations, particularly when it comes to patients with high-cost, complex needs. The question is: How can organizations save money without sacrificing the quality of care or increasing avoidable readmissions?
Editor's note: Jugna Shah, MPH, president and founder of Nimitt Consulting, writes a bimonthly column for Briefings on APCs, commenting on the latest policies and regulations and analyzing their impact on providers.
CMS' 2014 IPPS final rule redefined inpatient admissions when it implemented the 2-midnight rule, which requires a validated physician order, documentation of medical necessity, and the expectation of a stay crossing two or more midnights.
