CMS penalized more than half of hospitals participating in its Hospital Readmissions Reduction Program (HRRP) from fiscal year 2013 to 2017, according to a recent Health Affairs study. The average penalty increased from 0.29% in 2013 to 0.6% in 2017. Health Affairs referred to this as a modest penalty, bearing in mind that opportunities for penalization have increased since 2013.
Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules.
