The New Year brings a new change in the way DRG reimbursement is distributed. The reimbursement implications are significant, and many hospitals either have lost or will lose much needed federal funding, or collect sizeable incentive payments.
Which outcome will your hospital achieve?
As you know, one factor that determines whether your hospital receives an incentive payment or gets hit with a reduction in DRG reimbursement is inpatient satisfaction. That’s because Medicare’s Value Based Purchasing Program weighs inpatient satisfaction as 30% of a hospital’s performance score.
For this year, up to 1% of DRG reimbursement was at stake at underperforming hospitals. Next year, the percentage increases to 1.25% and increases again in 2017 to 2%. Even if yours is considered a top-performing hospital in its region, its DRG reimbursement may still be at risk because your facility is now being compared to the top 5% of ALL hospitals, with rolling benchmarks.
In anticipation of this change, hospital executives have been retraining staff and revising policies and processes with the goal of improving quality and increasing patient satisfaction at their facilities. Perhaps that’s what you’ve done, too.