News archive 2017

reimbursement hub home


Final Medicare Inpatient Rates for FY 2018

1
Select your area of interest
2
Contact details

We are always interested in engaging with you.

Let us know how we can help.

1
2
Contact details

August 4, 2017

Hospitals will see an increased $2.4 billion in overall Medicare spending for the inpatient care they provide Medicare beneficiaries during Fiscal Year 2018 (FY18). That is the result of a final rule recently issued by the Centers for Medicare & Medicaid Services (CMS) that updates payment rates and policies for hospital inpatient care during FY18, which begins October 1, 2017.

 

Highlights:

Rates: CMS will update the prospective payment rates that hospitals receive for treating Medicare beneficiaries by approximately 1.2%. This applies to hospitals that successfully report their quality performance and are meaningful users of electronic health records. CMS will update the payment rates for long-term care hospitals by 1.0%. 

 

Uncompensated Care: Hospitals with a disproportionate share of uncompensated care cases will receive $6.8 billion in FY 2018—an increase of about $800 million from FY 2017.

 

Hospital Acquired Conditions: Hospitals in the worst performing 25% of hospitals in reducing hospital acquired conditions will continue to experience a payment penalty of 1%, as required by existing law. CMS is still considering whether it should add outcomes-focused patient-safety measures related to falls with injuries, adverse drug events, glycemic events, and ventilator-associated events.

 

Readmissions: For FY 2018 and subsequent years, CMS will continue to reduce payments for excessive readmissions for heart attack, heart failure, pneumonia, chronic obstructive pulmonary disease, total hip/total knee arthroplasty, and coronary artery bypass graft. CMS is finalizing its proposal to judge a hospital’s performance in comparison to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full-benefit Medicaid.

 

Value-Based Purchasing: CMS is removing one quality measure and adopting two new ones in future fiscal years, as well as adjusting the weight of efficiency and cost-reduction measures in FY 2021 to reflect the implementation of condition-specific payment measures. CMS continues to consider whether to account for social risk factors in measuring quality and patient health outcomes.

Our site can best be viewed with the latest version of Microsoft Edge, Google Chrome or Firefox.