Eli's Rehab Report

Published on Wed Jun 01, 2016 PDF

If you offer therapy in a hospital, then you need to take note of some of the newer measures and programs listed in the IPPS and LTCH proposed rule for fiscal year (FY) 2017. They are:

The hospital readmissions reduction program (HRRP): This program aims to decrease a hospital’s base operating DRG payment, in case there are excess readmissions observed within a three-year observation window, for conditions including:

• Pneumonia, heart failure (HF),
• Total hip arthroplasty/total knee arthroplasty (THA/TKA),
• Acute myocardial infarction (AMI),
• Chronic Obstructive Pulmonary Disease (COPD).
• A fifth condition Coronary Artery Bypass Graft (CABG).

The Hospital IQR Program: There are four new claims-based measures for The Hospital IQR Program, and removal of 15 existing measures, for FY 2019. The Hospital Value-Based Purchasing (VBP) Program is in for expansion of the number of measure in near future.

Final takeaway: “The volume of the proposed changes is almost overwhelming,” says Duane C. Abbey, PhD, president of Abbey and Abbey Consultants Inc., in Ames, IA. “There are many different issues ... Most of the issues stem from overall payment, and thus financial projections are in order at the individual hospital level… Thus, hospitals will need to prepare to accommodate requirements in order to forestall any payment reductions. As appropriate, hospitals should be prepared to comment on the proposals in the IPPS update in the Federal Register, particularly those that are most egregious to them.”

Should you desire to offer your two cents on the proposals, CMS will accept comments on the proposed rule until June 17, 2016, and will respond to comments in a final rule to be issued by August 1, 2016. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection.