Healthcare Business News

CMS releases outpatient, ASC payment updates

By Andis Robeznieks
Posted: November 1, 2011 - 7:00 pm ET

The CMS has released a final rule with comment period updating Medicare payment policies and rates for hospital outpatient and ambulatory surgical center services. As the name implies, most provisions in the 1,552-page document are final (PDF) and go into effect Jan. 1, but there are certain issues—such as interim values—which the CMS is accepting comments on, and it will respond to the feedback in next year's final rule.

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Payment rates for the outpatient prospective payment system will increase by 1.9%. Also, according to a CMS news release, payment rates will be “adjusted”—as per instructions in the Patient Protection and Affordable Care Act—for “designated cancer hospitals” and this is expected to boost their payment by about $71 million (11.3%) above what they would have been paid.

Payments to ambulatory surgery centers will go up 1.6% and the rule establishes a quality-reporting program that includes four outcome measures and one for infection.

In addition, a pilot program is established in the rule that will allow more hospitals to participate in the Medicare electronic health-record incentive program.

The rule also includes measures and performance standards for the 2014 hospital value-based purchasing program, which was established by the healthcare reform law.

“Using the tools made available under the Affordable Care Act, CMS is moving aggressively to reform the payment and healthcare delivery systems to provide better care at lower costs through improvement,” CMS Administrator Dr. Donald Berwick said in the release.

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