Revenue Cycle in 2016 OHA Update
Dec. 11, 2015 Revenue Cycle in OHA Update December 11, 2015 AAHAM whats Up for 2016 Federal Medicare 2016 CY Hospital OPPS Final Rule
OHA Update Dec. 11, 2015 whats Up for 2016 Federal Medicare 2016 CY Hospital OPPS Final Rule Growing Pains for Medicare Hospital P-for-P Programs Value-Based Purchasing Rated Poor by GAO Comprehensive Care Joint Replacement Model Challenged Medicare Medical Review Programs Expanding RAC Contract Re-Bid Vacated; What Now? What About Medicaid RAC? ICD.10 Conversion Follow-up State Ohio Medicaid Hospital Policy and Payment Updates Medicaid EAPG OPPS Medicaid Episodes-of-Care Expanding into Payments Other Medicaid Initiatives AAHAM December 11, 2015 AAHAM Medicare CY 2016 OPPS Final Rule
Big Cut in Annual Update for Lab Services is Controversial Final Rule Out Oct. 30; Effective Jan. 1, 2016 (Mostly!) Usual Mix of Updates to APC Groups & Weights, Inpatient-Only Procedures and Quality Reporting Rule .2% Cut for Alleged Increases Related to Two-Midnight Rule Payments is Still in (for Now) CMS States it Will Comment Later Three Big Updates: Two-Midnight Inpatient Admission Policy Hardened QIO (Ohios is KePRO Area 4) Takes Over Post-Pay Reviews of Short-Stay Medical Necessity (Site of Service) Started Oct. 1; Some Details Available in Webinar Materials Significant Problems to be Referred to Medicare RAC Does Not Affect RAC Reviews of Physicians Order Reduced Annual Payment Update by 2% to Pay for Unbundled Lab Services Will Cause Negative Update for Most Hospitals in CY 2016 Watch for Advocacy/Legal Action on This AAHAM December 11, 2015 Medicare Pay for Performance Programs
OHA Update Dec. 11, 2015 Medicare Pay for Performance Programs The Medicare Update Factor is Under Siege Medicare Hospital Update Factor Productivity Offset Supplemental Reduction Factor Quality Pay-for-Reporting Reduction for Non-Compliance Value-Based Purchasing Pool Carve-Out Meaningful Use Reduction for Non-Compliance Healthcare-Acquired Conditions Penalty Readmissions Penalty Behavioral Offset AAHAM December 11, 2015 AAHAM Medicare IPPS Update & Payments at Risk Under Pay for Performance Programs
AAHAM December 11, 2015 Medicare P-for-P Programs
But What do They Add? Readmissions Reduction Policies Show Promise VBP Shows Little Shift in Hospitals Quality Performance that Would Not Have Occurred Without the Program VBP Eligible Hospitals Received