CMS has proposed sweeping changes to the Inpatient Prospective Payment System, including a new method for establishing DRG-payment weights and replacing the current DRGs with a classification system that more accurately reflects a patient's severity of illness. In addition, the recently enacted Deficit Reduction Act (DEFRA) requires a Present on Admission (POA) indicator for all secondary diagnoses reported on Medicare claims submitted after October 1, 2007.
CMS' proposed reforms and the provisions of the DEFRA are the most dramatic changes to hospital payment since DRGs were implemented in 1983. Hospital processes will be directly affected and providers will need to address the financial, budget, and compliance implications well in advance of implementation.
This Audio Webcast will provide an overview of current laws and proposed regulations, and offer a step-by-step process for conducting a financial gap analysis to measure the impact of the changes on your organization. You will also be given practical tools and strategies that will help you take a leadership role in ensuring the accuracy of the data used to fulfill pending regulatory requirements.
The Webcast also includes a case study focusing on The Johns Hopkins Hospital. All Maryland hospitals, including Johns Hopkins, are paid according to a new payment model that uses 3M APR-DRGs, a severity-based classification methodology, instead of Medicare DRGs to classify patients and determine payment rates. You'll learn how quantifying clinical differences in severity in all patient populations helps ensure that the data used to set payment rates and determine provider performance measurement is fair and equitable.