CMS Proposal Would Factor Patient Safety, Efficiency Into Hospital Pay Formula

The draft rule adds measures of patient safety and a financial assessment to determine whether hospitals are careful with Medicare's money. 

Kaiser Health News: Capsules: Medicare To Add Hospital Efficiency, Patient Safety To Payment Formula
Medicare is proposing a significant change in how it decides on hospital reimbursements, adding two measures of patient safety and a financial assessment of whether hospitals are careful stewards of Medicare's money (Rau, 4/24).

Modern Healthcare: CMS Proposes Small Pay Hike For Acute-Care Hospitals
In a proposed rule, the CMS said it expects operating payments to acute-care hospitals will increase by about 0.9% in 2013. That figure includes a 2.3% net payment update—which accounts for inflation, productivity improvements, coding changes and other adjustments—and other policies included in the rule. Overall, the CMS said it expects total Medicare spending on inpatient hospital services will increase by about $175 million in fiscal 2013 (Zigmond, 4/24).

HealthBeat: CMS Issues Proposed Inpatient Hospital Payment Rule
The agency added in a news release that "the rate increase, together with other policies in the proposed rule and projected utilization of inpatient services, would increase Medicare's operating payments to acute care hospitals by approximately 0.9 percent in FY 2013." This means total Medicare operating payments to acute care hospitals would rise by a total of about $904 million in fiscal 2013. However, because of expiring statutory provisions providing special temporary increases in payments, plus other proposed changes, CMS said "total Medicare spending on inpatient hospital services will increase by about $175 million in FY 2013" (Reichard, 4/24).

In other Medicare news, the program's chief actuary argues that its financial well-being is even worse than the latest Trustees' report suggests, and the New York Times reports that Social Security Disability Insurance payments are spiralling out of control. 

Kaiser Health News: Capsules: An Even Bleaker Prognosis For Medicare?
If readers can bear the first 276 pages of bad news in the annual Medicare trustees report,  released Monday, they will come to several pages in which Medicare Chief Actuary Richard Foster argues the program’s financial future is even bleaker than what the trustees suggest. Foster acknowledges the trustees did exactly the job they were asked to do, basing their findings on current law, including the 2010 overhaul (Werber Serafini, 4/24).

The New York Times: Disability Insurance Causes Pain
Every year, when the trustees of Social Security and Medicare publish their report on the programs' finances they set off a round of partisan bickering about the solvency of the twin programs covering pensions and health care for retired Americans. Every year, a vitally important issue gets lost in the din: disability insurance payments, which account for almost $1 out of every $5 spent by Social Security, are growing out of control (Porter, 4/24).

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