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Final Medicare Hospital Rates for FY 2019

Final Medicare Hospital Rates for FY 2019

New Medicare policies for Fiscal Year 2019 will require hospitals to increase interoperability of medical data, share their prices online, and report how well they performed on a narrower set of quality measures. The changes are the result of the final rule from the Centers for Medicare & Medicaid Services (CMS) that updates Medicare hospital inpatient payment policies and rates for FY 2019, which begins on October 1, 2018.




Interoperability: CMS continues to push hospitals to increase the interoperability of health data among providers and to make it easier for patients to obtain their own health information. Toward this end, CMS said it narrowed the set of electronic health record performance measures to those most likely to contribute to interoperability and patient access. Starting in January 2019, the agency is also requiring eligible hospitals to use the 2015 Edition of CEHRT.   


Transparent Prices: CMS is finalizing its policies to require hospitals to publish their prices online and to update them at least annually.  


Quality Measures: In its four quality and value-based payment programs, CMS is reducing the number of measures on which hospitals are required to report their performance. These include the Inpatient Quality Reporting, Value-Based Purchasing, Hospital-Acquired Conditions Reduction, and Readmissions Reduction Programs. The final rule eliminates a total of 18 measures and removes another 25 that CMS says duplicate others.


Payments: CMS will increase payment rates by about 1.85% for hospitals that successfully participate in the hospital quality reporting program and are meaningful users of electronic health records. CMS projects that the increase, together with other changes in inpatient hospital payment policies, will increase Medicare spending on inpatient hospital services in FY 2019 by approximately $4.8 billion.


See CMS fact sheet

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