Provider groups blast ‘woefully inadequate’ CMS pay update for inpatient care
Hospital groups are blasting what they say is a “woefully inadequate” payment update for inpatient providers, announced by CMS on April 10.
The agency is proposing a 2.8% increase in payment rates for acute care hospitals reimbursed under the 2024 Inpatient Prospective Payment System. However, providers would only receive the pay bump if they exhibit meaningful use of electronic health records and successfully participate in the Hospital Inpatient Quality Reporting program, the ACR noted Thursday.
This would amount to a hospital market basket percentage increase of 3% (minus a 0.2 percentage-point productivity adjustment), or an increase in hospital payments of about $3.3 billion next year.
Trade groups including the American Hospital Association and Federation of American Hospitals blasted the proposal on Monday.
“The AHA is deeply concerned with CMS’ woefully inadequate proposed inpatient hospital payment update of 2.8% given the near decades-high inflation and increased costs for labor, equipment, drugs and supplies,” Ashley Thompson, senior VP of public policy analysis and development, said in a statement. “Without more substantial updates in the final rule, hospitals’ ability to continue caring for patients and providing essential services for their communities will be threatened,” she added later.
In its news update, the American College of Radiology said it’s working to produce a detailed summary of the rule and any radiology-related impact. Topics of note, ACR said, would include new technology add-on payments, reimbursement related to graduate medical education costs, and any updates to the Inpatient Quality Reporting program. In the meantime, the AHA offered some further details on these three subjects.
With the COVID public health emergency slated to end in May, any discharge involving qualified products will still be eligible for the new technology add-on payment. This will continue on until Sept. 30, AHA noted, which is the end of FY 2023.
Aiming to boost the number of physicians in remote areas, CMS is proposing to allow rural emergency hospitals to train residents and receive graduate medical education payments. Beginning with FY 2024 on Oct. 1, such hospitals can include full-time equivalent residents training at their institution in direct GME and indirect medical education FTE counts for Medicare payment, the association noted. Rural emergency hospitals also have the option to incur direct GME expenses and receive payment based on “reasonable costs for those training.”
And finally, CMS is proposing to add three new clinical measures as part of the Inpatient Quality Reporting program. This would begin with the 2025 calendar reporting year or the 2027 fiscal payment year. Of note for radiology, the agency is adding a measure covering excessive radiation dose or inadequate image quality for diagnosis using CT in adults. The other two new measures would pertain to pressure injuries and acute kidney harm.
You can read much more on the proposed rule in the American Hospital Association’s breakdown, and find a detailed fact sheet from CMS here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.