Payment Matters: Two Hospital Quality Initiatives Begin October 1, 2012


Hospitals began feeling the impact, for better or for worse, with respect to two quality initiatives established by the Affordable Care Act, effective October 1, 2012.

As discussed in our article "In Seeking to Minimize Readmissions, Hospitals Must Remember Patient Choice Requirements," CMS is now reducing Inpatient Prospective Payment System (IPPS) payments to hospitals for readmissions relating to three specific measures (acute myocardial infraction, heart failure and pneumonia) as of the beginning of this month. Hospitals received information regarding their Excess Readmission Ratio by letter dated June 20, 2012, and were expected to submit any concerns regarding this data by July 19, 2012. CMS published the Excess Readmission Ratio results for all hospitals in the FY 2013 IPPS Final Rule.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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