General Question for the Week of December 9, 2019

Question:

What are the supposed “other” payment adjustments CMS could subject hospitals to under the 2020 IPPS final rule?

Answer:

CMS specifies that individual hospitals could be subject to other payment adjustments such as:

• “Penalties for excess readmissions, which reflect an adjustment to a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full benefit Medicaid
• Penalty (1 percent) for worst-performing quartile under the Hospital-Acquired Condition Reduction Program
• Upward and downward adjustments under the Hospital Value-Based Purchasing Program.”