Congress' nonpartisan investigative arm reported that 91% of hospitals paid by Medicare receive some dispensation or add-on to the program's standard payment system.
The Inpatient Prospective Payment System was designed to maximize “cost-control, efficiency and access” when it was launched 30 years ago, according to the Government Accountability Office report. But Congress has piled on an accumulating number of exemptions and carve-outs for various types of hospitals.
The agency's other findings include that 63% of hospitals qualify for at least one of four types of payment increases; 28% of hospitals receive an exemption from IPPS through the critical-access hospital program; and Congress has enacted 15 changes to boost payments for various groups of hospitals.
For nearly all hospitals, those tweaks have added up to payments that exceed Medicare's standard rates. But some hospitals have benefited more than others. For instance, the GAO found 70 hospitals received four types of additional payments on top of the standard Medicare reimbursements.