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Hospital Value-Based Purchasing Program Results for FY 2017
The Hospital Value-Based Purchasing (VBP) Program adjusts what Medicare pays hospitals under the Inpatient Prospective Payment System based on the quality of care they provide to patients. For FY 2017, the law requires that the applicable percent reduction, the portion of Medicare payments available to fund the program’s value-based incentive payments, increase from 1.75 to 2 percent of the base operating Medicare Severity Diagnosis-Related Group (MS-DRG) payment amounts for all participating hospitals. CMS estimates that the total amount available for value-based incentive payments for FY 2017 discharges will be approximately $1.8 billion. The Hospital VBP incentive payment adjustment factors for FY 2017 are posted in Table 16B on the FY 2017 Final Rule and Correction Notice Tables webpage. For FY 2017, more hospitals will have an increase in their base operating MS-DRG payments than will have a decrease. In total, over 1,600 hospitals will have a positive payment adjustment.
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Recovery Audit Contractor Awards
On October 31, CMS announced the awards for the Medicare Fee-for-Service (FFS) Recovery Audit Contractor (RAC) contracts. Mississippi is in region 2 and will have Cotiviti, LLC as the contractor. The RACs in Regions 1 through 4 will perform postpayment review to identify and correct Medicare claims that contain improper payments (overpayments or underpayments) that were made under Part A and Part B, for all provider types other than Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Home Health/Hospice. The Region 5 RAC will be dedicated to the postpayment review of DMEPOS and Home Health/Hospice claims nationally.
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Meaningful Use 'flexibility' included in OPPS 2017 final rule
As part of the final Hospital Outpatient Prospective Payment System rule for 2017 unveiled Tuesday, the Centers for Medicare & Medicaid Services has eased several requirements for participants in the Meaningful Use program. For 2016 and 2017, all returning participants to the program will only have to attest to the meaningful use of electronic health records for 90 consecutive days, as opposed to an entire year. CMS, in July’s proposed rule, called for a shortened reporting period for eligible providers (EP), eligible hospitals (EH) and critical access hospitals (CAH).
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Open enrollment off to strong start on state, federal exchanges
The Affordable Care Act's fourth open enrollment kicked off Tuesday just a week after HHS announced double-digit premium hikes for some unsubsidized exchange plans, but the news didn't seem to spook early-bird shoppers from signing up for 2017 coverage. Open enrollment kicked off Nov. 1 for federal and state-based exchanges and will run through Jan. 31. HHS said more health insurance shoppers got an early start this year, submitting 60,000 applications for coverage through the federal marketplace in the first six hours of open enrollment Tuesday, up 50% compared to the early hours of last year's open enrollment. In total, there were about 150,000 applications submitted over the first day, and on Wednesday “tens of thousands of consumers continue to submit applications,” HHS spokeswoman Marjorie Connolly said.
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AHIMA New Membership Model
AHIMA will soon launch its new membership model. This new model offers it's members brand-new and expanded benefits, additional choices, and flexibility. It will provide a more valuable, enhanced, and personalized membership experience. The expected launch date is early December. You don't have to act until it's time to renew your membership. Please watch the announcement launch video to learn more about the new model and exactly what it means for you, and be on the lookout for additional information.
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