Hospitals are likely to see some significant changes in the way that Medicare reimburses for inpatient services in the next couple of years, according to the calendar year (CY) 2020
Inpatient Prospective Payment System
(IPPS) final rule that was published on August 16, 2019, and the announcement by the
Centers for Medicare & Medicaid Services
(CMS) on August 19, 2019 that it would change the quality “
star ratings
” system on Hospital Compare, beginning in 2021.
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The CMS, in response to President Donald Trump’s June 24, 2019 executive order entitled, “
Improving Price and Quality Transparency in American Healthcare to Put Patients First
,” has proposed “
historic changes to various healthcare payment systems in an effort to “lay [] the foundation for a patient-driven healthcare system.
” On August 9, 2019, CMS released the proposed rule for the CY
2020 Medicare Hospital Outpatient Prospective Payment System
(OPPS) and
Ambulatory Surgical Center
(ASC)
Payment Systems
, which includes significant changes to both payment systems.
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On July 29, 2019, the CMS proposed significant changes to both fulfill the Trump Administration’s “
Patients over Paperwork
” initiative and continue the paradigm shift in the healthcare reimbursement environment from a volume-based to a value-based system. The 1,704-page
Medicare Physician Fee Schedule
(MPFS) proposed rule, which was published on August 14, 2019, includes proposed updates to payment policies, payment rates, and quality provisions for services rendered under the MPFS, as well as the proposed changes to the
Quality Payment Program
(QPP) established by the 2015
Medicare Access and CHIP Reauthorization Act
(MACRA).
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A recent
Modern Healthcare
survey found a rapidly increasing shift in hospitals seeking physicians for their chief executive officer (CEO) positions. The management shift to physician executives has been ongoing for the past several years (as of 2014, only about 5% of all hospitals were physician-led), starting first with academic medical centers, and subsequently expanding to community health systems and large integrated delivery systems. This shift may be due to a number of reasons, as discussed within this article.
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HCC is excited to welcome
Paul Doelling, MHA, FACMPE
, as a Senior Financial Analyst. Paul has over 25 years of healthcare valuation and operational management experience and he has previously served as an administrator for a number of mid to large-sized independent and hospital-owned physician practice groups. During that time, he has participated in numerous physician integration and affiliation initiatives. Paul has authored peer-reviewed and industry articles, as well as served as faculty before professional associations such as the Medical Group Management Association (MGMA) and the Healthcare Financial Management Association (HFMA). He will be a valuable addition to the service of our clients.
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Advanced Distance Education to Launch in 2019
The
Institute for Healthcare Valuation
(IHV) &
Consultants' Training Institute
(CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will launch in 2019 and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leader
Health Capital Consultants
, alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.
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