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CHA DataSuite has issued a number of hospital-specific analyses for federal fiscal year (FFY) 2023 Medicare final rules.
The analyses include:
Inpatient prospective payment system (IPPS) final rule. This is intended to show how Medicare inpatient fee-for-service (FFS) payments would change from FFY 2022 to FFY 2023 based on the policies set forth in the final rule. The analysis compares the year-over-year change in operating, capital, and uncompensated care (UCC) IPPS payments and includes breakout sections that provide detailed insight into specific policies that influence IPPS payment changes, including:
- Provider type changes
- Market basket update
- Affordable Care Act (ACA)-mandated market basket adjustment
- MACRA-mandated coding adjustment
- Medicare Severity Diagnosis-Related Group (MS-DRG) weight 10% reduction cap budget neutrality
- Wage index/geographic adjustment factor changes
- Disproportionate share hospital-UCC payment changes
- Change in hospital-specific rate
- MS-DRG updates
- Quality-based payment adjustments
- Low-volume adjustment changes
Dollar impacts in this analysis may differ from those provided by other organizations due to differences in source data and analytic methods.
CHA members are invited to register for DataGen’s webinar on the FFY 2023 IPPS final rule and analysis on Sept. 14 at noon (PT). Registration is required.
Inpatient psychiatric facility prospective payment system final rule. The analysis is intended to show providers how Medicare FFS payments would change from FFY 2022 to FFY 2023 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members.
Changes modeled in this analysis include market basket update, ACA-mandated market basket adjustment, wage index budget neutrality, 5% wage index cap budget neutrality, and wage index and labor share.
Medicare inpatient rehabilitation facility prospective payment system final rule. The analysis is intended to show providers how Medicare FFS payments would change from FFY 2022 to FFY 2023 based on the final rule. A detailed summary of the final rule is available for CHA members.
Changes modeled in this analysis include the market basket update, ACA-mandated market basket reductions, budget neutrality adjustments, wage index and labor share updates, changes in rural status, and case-mix group updates.
For FFY 2023, like in FFY 2022, all three facility-level adjustment factors — low-income percentage, teaching, and rural — are kept at the FFY 2014 level.
Medicare long-term care hospital (LTCH) PPS final rule. The analysis is intended to show how Medicare LTCH FFS payments may change from FFY 2022 to FFY 2023 based on the policies set forth in the final rule. The impact of site-neutral payments for certain cases has been incorporated into this analysis.
The Bipartisan Budget Act mandates an IPPS-equivalent payment rate for all discharges for LTCHs with fewer than 50% of their cases eligible for LTCH standard payment. This percentage and estimated impact if the LTCH fails to meet the threshold is displayed where applicable.
Skilled-nursing facility (SNF) PPS final rule. The analysis is intended to show providers how Medicare FFS payments will change from FFY 2022 to FFY 2023 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members.
As the Medicare cost reports have yet to be updated to account for the Patient Driven Payment Model (PDPM) methodology, SNF PPS payments for FFY 2022 are based on FFY 2020 SNF claims sourced from the calendar year (CY) 2019-20 SNF standard analytical files limited dataset 100% claims data. SNF PPS payments for FFY 2023 are calculated by applying all update factors to the FFY 2022 totals. Wage indexes, labor shares, and the per-diem payment rates are from the FFY 2022 final rule and the FFY 2023 final rule. SNF value-based purchasing (VBP) adjustments are from the final FFY 2022 SNF VBP performance from Nursing Home Compare, and from the FFY 2023 SNF final rule.
Changes modeled in this analysis include the market basket update, ACA-mandated productivity reduction, forecast error adjustment, wage index budget neutrality, wage index and labor-related share impact, PDPM parity adjustment, and VBP year-over-year adjustment.
For any questions on any of the analyses, please contact us at datasuitereports@calhospital.org.
