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  • Proposed CMS Rules for Hospitals Would Cut Payments, Institute Function and Mobility Measures

    A $241 million reduction in payments to acute-care hospitals and a slight payment increase (.8%) for long-term-care hospitals (LTCH) are among the proposed Medicare payment and policy changes for hospitals issued by the Centers for Medicare and Medicaid Services. The proposed rule (.pdf) would also institute functional status quality measures around mobility and function for LTCHs. If finalized, the policies will be effective October 1, 2014.

    The $241 million reduction would affect roughly 3,400 hospitals nationwide, while the .8% increase to LTCHs would affect 435 facilities and amount to an increase of $44 million. Additionally, hospitals that successfully participate in Medicare's quality reporting system and meet the criteria for meaningful use of health information technology will receive a 1.3% payment increase.

    In an acknowledgment of the benefits of early mobilization and rehabilitation, the policies also establish 2 functional status quality measures for LTCHs. One of the measures is focused on increasing the percentage of LTCH patients with admission and discharge functional assessments and care plans that addresses function; the second measure is centered on change in mobility among LTCH patients who require ventilator support. Both measures would be implemented in 2018.

    Also included in the proposed rule is a call for suggestions from providers on ways Medicare might handle reimbursement for short hospital stays. The request for input is being made in response to objections from health care providers on the "2 midnight" rule that CMS has yet to fully enforce. Last month, the American Hospital Association (AHA) announced that it was filing a lawsuit to strike down that rule.

    APTA will submit comments on the proposed rule by the June 30 deadline. The final rule will be released by August 1.


    • It truly was frightening to learn about the "2-midnight" rule, implying that very sick patients may have to foot the bill if Medicare does not pay for "observation" that really should have been an actual admission. I hope the rule is struck down.

      Posted by Ellen Colley on 5/3/2014 1:49 PM

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