CHA has provided member hospitals and health systems with hospital-specific CHA DataSuite analyses showing how Medicare inpatient fee-for-service (FFS) payments will change from federal fiscal year (FFY) 2019 to 2020 based on policies in the Centers for Medicare & Medicaid Services’ (CMS) FFY 2020 inpatient prospective payment system (IPPS) final rule.
The analysis compares the year-over-year change in operating, capital, and uncompensated care IPPS payments, and includes breakout sections that provide detailed insight into specific policies that influence IPPS payment changes, including:
- Potential payment penalties under the inpatient quality reporting and electronic health record (EHR) incentive programs
- The impact of CMS’ adjustment to the wage index of hospitals in the bottom quartile of wage index values nationally to reduce wage disparities
- Quality-based payment adjustments
- Disproportionate share hospital (DSH) uncompensated care (UCC) payments
- CMS’ use of solely FFY 2015 Medicare cost report worksheet S-10 data for FFY 2020 UCC payments
This analysis does not include estimates for outlier payments, payments for services provided to Medicare Advantage (MA) patients including indirect medical education payments for MA patients, or EHR incentive payments. It also does not include modifications in FFS payments as a result of hospital participation in new payment models being tested under Medicare demonstration/pilot programs.
Final rule changes modeled in the analysis include provider type changes, a market basket update, Affordable Care Act-mandated market basket reductions, coding adjustment reductions mandated by the Medicare Access and CHIP Reauthorization Act, wage index/geographic adjustment factor values, DSH-UCC payment changes, change in hospital-specific rates, MS-DRG updates, quality-based payment adjustments, and low volume adjustment changes.
More information is available in the analysis description.