Payment Matters: CMS Capitulates, Issues Ruling Granting Quality & Efficiency: Key Themes in FY 2012 IPPS Proposed Rule

Baker Donelson
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The Centers for Medicare and Medicaid Services (CMS) continued its focus to seek high quality care and reduction of costs with the fiscal year (FY) 2012 inpatient prospective payment system (IPPS) proposed rule. Below is a summary of some of the key quality proposals in the IPPS proposed rule, including (1) the Hospital Inpatient Quality Reporting (IQR) program; (2) the Hospital Value Based Purchasing (VBP) program; (3) the Hospital Readmissions Reduction Program and (4) the Hospital Acquired Conditions payment limitation.

CMS is seeking industry input on these quality initiatives to ensure compliance and success of these quality programs. Although these quality programs currently target hospital payments, these programs contemplate partnerships between hospitals and community providers and in the future may expand to other providers. Comments related to the FY 2012 IPPS Proposed Rule are due to CMS on June 20, 2011.

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