CMS proposed regulation on long-term acute-care hospital payments also would revise payments for teaching hospitals. The proposal would require teaching hospitals pay at least 90% of the total costs of training residents in the nonhospital setting. It also would set the marketbasket updates for LTACs at 0.71% in rate year 2008 and extend the so-called 25% threshold, which dictates Medicare payments to LTACs based on a percentage of patients admitted from an individual hospital. Overall, the CMS said it expects to make about $4.4 billion in Medicare payments to approximately 390 long-term acute-care hospitals in 2008.
Revenue for continuing-care retirement communities rose more than 10% to $18 billion in 2005, according to a report by the U.S. Census Bureau. The annual survey on the healthcare and social-assistance industries tracks revenue for firms with paid employees. The data for the continuing-care retirement segment reflects estimates for both taxable and tax-exempt firms. By comparison, revenue increased about 6% to $16.3 billion in 2004. The data show were continuing alternatives to institutionalization, said Richard Narad, a professor of health services administration at California State University, Chico.
The American Hospital Association said it is concerned many pay-for-performance approaches have resulted in payment penalties, inequities and other serious consequences that have adversely affected hospitals and the patients they serve. In a Jan. 24 comment letter to the CMS, the AHA said it thinks that pay-for-performance, or value-based purchasing, holds merit, but there are important considerations the CMS should take into account to ensure such a programs success. For example, a pay-for-performance program should reward all hospitals rather than only the top 10%.
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