The proposed rule would change the severity of three diagnosis codes describing homelessness from “non-complication or comorbidity” to “complication or comorbidity.” Doing so, according to the agency’s April 10 news release, is in line with the Biden administration’s priorities to support healthcare access for underserved and under-resourced communities. For some facilities, the proposed rule would also “result in higher payment for certain hospital stays.”
“With this proposed rule, CMS is more accurately paying hospitals and recognizing for the first time that homelessness, as a social determinant of health, also impacts resource utilization,” Meena Seshamani, MD, PhD, deputy administrator for CMS, said in a statement. “Creating incentives for hospitals to provide excellent care for underserved populations lays the foundation for a health system that delivers higher-quality, more equitable, and safer care for everyone.”
According to the fact sheet on the newly proposed change, CMS noted its proposed rule is “based on the higher average resource costs of cases with these diagnosis codes compared to similar cases without these codes.”
The proposed rule is now open for a 60-day comment period before moving forward.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.