What’s happening: CHA DataSuite has issued a hospital-specific analysis of the inpatient post-acute care transfer (PACT) adjustment policy that shows the estimated impact on Medicare inpatient fee-for-service (FFS) payments.
What else to know: The analysis also shows corresponding Medicare severity diagnosis-related group (MS-DRG) volumes from the inpatient prospective payment system (IPPS) during federal fiscal years (FFYs) 2020-25.
The post-acute settings in this analysis include:
- Skilled-nursing facilities
- Inpatient rehabilitation facilities
- Long-term care hospitals
- Inpatient psychiatric facilities
- Cancer and children’s hospitals
- Patient’s home, including a Home Health plan of care that begins within three days of discharge
- Hospice care
An inpatient PACT adjustment occurs when a Medicare beneficiary in an IPPS hospital is transferred to a post-acute setting and the inpatient length of stay is less than the geometric mean. The transferring hospital is paid per diem for that beneficiary, capped at the full MS-DRG amount for the discharge. The Centers for Medicare & Medicaid Services may flag high-cost MS-DRGs as eligible for a special payment methodology — under which the transferring hospital receives 50% of the full MS-DRG payment, plus a per diem payment, with the total capped at the full MS-DRG amount.
This release includes the major diagnostic category (MDC) report that shows the number of claims and potential impact of the PACT policy for each MDC category. Also available is a copy of each year’s Table 5, filtered to show DRGs subject to the PACT policy.
This content is restricted to members.
