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Tag: Low Volume Hospital

Estimated FFY 2023 IPPS Medicare Paymentsfor Your Hospital(s)

 

Toyon is pleased to provide complimentary access to estimated hospital payments
per the Medicare
Federal Fiscal Year (FFY) 2023
IPPS Proposed Rule. 
 
  Please visit Toyon’s website to access a dashboard analysis of estimated FFY 2023 Medicare Fee for Service (FFS) IPPS payments for your hospital(s). Below is an animation on how to interact with the dashboard to see estimated payments and details on CMS IPPS rates for your hospital(s).   

Over the coming weeks, Toyon will provide a summary with further insight into the FFY 2023 IPPS Proposed Rule. You and your team are also invited to Toyon’s FFY 2023 IPPS Webinar on Friday, May 20, from 10 a.m. PDT to 11 a.m. PDT. To sign up for the IPPS Proposed Rule Webinar, please register here.    
 
Below are Toyon’s initial observations impacting Proposed FFY 2023 IPPS rates: 
  • Medicare discharges and Case Mix Indices (CMI) – For projecting future reimbursement, CMS provides discharges and CMI from 2021 (i.e., MEDPAR data) impacted by COVID-19. In FFY 2022, CMS provided Medicare discharges and CMI using pre-COVID-19 data (2019). In the dashboard reports, Toyon holds discharges and CMI constant using the values provided in the FFY 2023 Proposed Rule.   
  • Alternative Rates for FFY 2023 – CMS provides two separate sets of base rates and variables for FFY 2023 rate setting. CMS is proposing rates are updated by factors projecting fewer COVID-19 hospitalizations in FFY 2023 than in FFY 2021. In CMS’s alternative rates, CMS does not make an adjustment projecting a decline in COVID-19 hospitalizations from FFY 2021 to FFY 2023.   
  • Uncompensated Care (UC) DSH – CMS is proposing UC DSH payments of $6.6 billion, a reduction of $563M as compared to FFY 2022 ($1.8 billion reduction compared to FFY 2021). Decreasing UC DSH funding is an important area of focus for FFY 2023, and Toyon will be sending comments to providers and CMS, aimed at increasing this funding.    
  • Wage Index – CMS is proposing to cap wage indices so providers can experience a decrease of no more than 5% as compared to prior year (i.e., FFY 2022).   
  • Low Volume Adjustment and Medicare Dependent Hospital Status – Unless otherwise extended by law, these provisions are set to expire for FFY 2023. Therefore, CMS does not propose rate adjustments for these provisions in the FFY 2023 Proposed Rule. 
  • Value Based Purchasing (VBP) Adjustment – CMS is also proposing to not calculate a Total Performance Score (TPS) for any hospital and to instead award all hospitals a VBP amount for each discharge that is equal to the amount withheld, which is 2% of the base operating rate. Toyon’s estimated VBP amount for FFY 2023 is estimated at 2% of base rate payments.   
 
We look forward to our next update on the FFY 2023 IPPS Proposed Rule. In the meantime, please feel free to contact Fred Fisher at 888.514.9312, or fred.fisher@toyonassociates.com with any questions or comments. 
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