Medtech Insight is part of Informa PLC

This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC’s registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.

This copy is for your personal, non-commercial use. For high-quality copies or electronic reprints for distribution to colleagues or customers, please call +44 (0) 20 3377 3183

Printed By

UsernamePublicRestriction
UsernamePublicRestriction

’08 inpatient proposal includes severity adjustments

This article was originally published in The Gray Sheet

Executive Summary

CMS proposes April 13 to adjust hospital inpatient payment weights based on patients' degree of illness beginning Oct. 1. The proposed system, which adds 207 payment levels to the current system, uses the existing 538 diagnosis related groups (DRGs) as a starting point and incorporates the complexity of procedures into payment calculations. Overall, DRGs for the most severely ill patients will be paid an average of $44,219, compared with the $24,538 now paid on average to patients with complicating comorbidities, according to the agency. CMS proposes to offset expected increases in payments related to the change with an across-the-board payment cut in FY 2008 and 2009. The RAND Corporation will continue to evaluate the proposed DRG system and other severity-adjusted systems for a report due Sept. 1 (1"The Gray Sheet" April 2, 2007, p. 22). CMS also explains that it does not plan to adjust payments for charge compression this year as the device industry had hoped because it did not have enough time to evaluate the impact of that change (2"The Gray Sheet" March 26, 2007, p. 11). Public comments on the 3proposal are due June 12...

You may also be interested in...



Severity Adjusted DRG System Unlikely In FY 2008, Report Suggests

More analysis is needed to determine the impact of incorporating severity-adjusted weights into the Medicare hospital inpatient payment system, according to an interim CMS-commissioned report

CMS Report Validates Industry’s Stance On Charge Compression

Adjusting for the effects of "charge compression" could significantly boost CMS inpatient payments for high-cost, device-dependent procedures, a recently released analysis from RTI International confirms

Moderna Files COVID-19 Vaccine After Second Impressive Read-Out

Second read-out maintains 94% level of efficacy, with a very early signal that it could outperform Pfizer’s rival mRNA candidate in preventing severe cases.

UsernamePublicRestriction

Register

LL1134478

Ask The Analyst

Ask the Analyst is free for subscribers.  Submit your question and one of our analysts will be in touch.

Your question has been successfully sent to the email address below and we will get back as soon as possible. my@email.address.

All fields are required.

Please make sure all fields are completed.

Please make sure you have filled out all fields

Please make sure you have filled out all fields

Please enter a valid e-mail address

Please enter a valid Phone Number

Ask your question to our analysts

Cancel