The proposed cut is intended to offset the effect of coding changes in the classification of patients. CMS claims the coding changes have caused hospitals to receive increased reimbursement. However, critics of the change have argued that the increased reimbursements could be due to truly sicker patients being treated by hospitals. This may be due, in part, to healthier patients being treated as outpatients.
The first study, by The Moran Company, suggests that CMS did not adequately isolate documentation and coding from other factors when calculating changes in case mix, according to the report.
The second study, by the Partha Deb, an economics professor at City University of New York, suggests that Medicare beneficiaries with inpatient status are indeed sicker than in the past.
Members of both the Senate and the House have sent letters to CMS urging the agency to reconsider the cut, and the American Hospital Association has shared the results of the studies with the agency.
Read the AHA News Now report on inpatient acuity.
Read other coverage on the Medicare inpatient pay cut.
– CMS Issues Proposed Rule for 2011 Inpatient Payment System
– Senate Urges CMS to Reconsider 2.9% Payment Cut to Hospitals
– House Urges CMS to Reconsider 2.9% Payment Cut to Hospitals in FY 2011
