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We’re taking a very close look at the FY19 IPPS Final Rule
We’ll take an intense look at four segments of the rule as well as the continuum of options hospitals have for reporting.
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Rate Advisor
We analyze hospital prices at the procedure code level and present an analysis of suggested rate changes designed to enhance the defensibility of proposed pricing with sensitivity to financial impact.
Contract Concierge
Coming soon! Contract benchmarking, modeling, and measurement through personal consulting with industry experts.
Strategic Advisor
We utilize extensive proprietary and public data sources to create fact-based, actionable plans to address specific client objectives.
HospitalDx®
Web-based software that creates custom analyses of financial/operating strengths, weaknesses, and opportunities. Utilizes client-submitted claims data as well as national public-use data.
Check Out The Latest Hospital Finance News!
Friday, September 07, 2018
CMS reports an estimated increase by 2.4 percent for FY 2019 in overall payments to hospitals paid under the IPPS. This increase is due to the applicable percentage increase and changes to policies related to MSDRGs, geographic adjustments, and outliers. National standardized amount increases by 1.85 percent. Hospitals paid under the hospital-specific rate will receive a 1.35 percent hospital update.
The annual hospital update includes:
9 percent market basket update
8 percentage point reduc...
Thursday, September 06, 2018
To what extent is Wage Index based on payment CBSA changing from FY 2018 to FY 2019?
*Data Source: CMS, FY 2018 & 2019 IPPS Final Rule Impact Files, FY 2019 URSPA variable
*Data Source: CMS, FY 2018 & 2019 IPPS Final Rule Impact Files, FY 2019 URSPA variable
Based on the data above, the clear majority of hospitals are experiencing an increase or decrease less than 5% or no change at all (92%).
Why should hospitals be aware?
Even small changes with wage index (WI) combined with MSDRG...
Thursday, September 06, 2018
Version 36 incorporates changes to our MSDRG list as well as associated relative weights. From FY 2018 to FY 2019, 742MSDRGs are present in both versions.
Does FY 2019 (MSDRG V36) involve any new or deleted MSDRG?
It sure does! Eleven (11) MSDRGs are removed for FY 2019 and eighteen (18) MSDRGs have been created.
To what extent is Relative Weight changing from FY 2018 to FY 2019?
*Data Source: CMS, FY 2018 & 2019 Table 5
*Data Source: CMS, FY 2018 & 2019 Table 5
Based on the dat...
Thursday, September 06, 2018
Remove – Remove – Remove!
CMS’s strategy for a holistic quality payment program, the FY 2019 IPPS Final Rule, involves several removed measures to prevent duplication across programs in which is stated as considered causing unnecessary complexity or unnecessary costs. This focus on removal is ultimately positive and will help reduce administrative burden on providers.
“Regulatory reform and reducing regulatory burden are high priorities for CMS.” (CMS, FY 2019 IPPS Final Rule)
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