2019 IPPS Proposed Rule Released by CMS

WHA’s PricePoint positioned as a solution for proposed new transparency rules

April 27, 2018

CMS released the 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule April 24. The rule is open for public comment until June 25, and rule provisions would take effect October 1, 2019.

WHA staff are in the process of analyzing the rule and will provide more details in the weeks ahead. A brief summary of the key provisions follows below.

Hospital rate changes
Acute care hospitals participating in CMS quality programs will receive a 1.75 percent operating payment rate increase.
Updates are made to uncompensated care, capital and low-volume hospital payments.
Uncompensated care payments will increase by $1.5 billion compared to fiscal 2018.

Price transparency
Hospitals are required to publish a list of their standard charges online, and the rule specifically seeks feedback on what information should be reported. Public transparent reporting of hospital prices has been a Wisconsin strength for over a decade, achieved through the use of WHA‘s innovative transparency tool PricePoint, which is currently licensed to 10 other states.

Meaningful measures
Numerous measures deemed duplicative, excessively burdensome or “topped out” are eliminated.
Documentation requirements are reduced.
Accounting for social risk factors is improved.

Meaningful use update
Meaningful use will shift to a focus on interoperability and flexibility, and the rule specifically seeks feedback on enhancing interoperability.
The CMS fact sheet on this rule is available.

This story originally appeared in the April 27, 2018 edition of WHA Newsletter