Medicare prospective payment without separate urban and rural rates
نویسندگان
چکیده
The elimination of urban-rural differences in the Medicare prospective payment system (PPS) standard rates implies a need to re-examine all the PPS payment adjustments. Refinements for case mix, outliers, and the wage index can make a significant contribution to avoiding payment disparities in a single-rate system. However, changes in the adjustments for teaching and disproportionate-share (DSH) hospitals are also needed. The typically urban location of these hospitals makes it difficult to balance PPS payments and costs among major groups of urban and rural hospitals without some form of higher payment for all hospitals located in large urban areas.
منابع مشابه
Calculating and using the area wage index of the Medicare inpatient hospital Prospective Payment System.
When Congress created the Medicare Prospective Payment System (PPS) for hospitals in 1983, it established separate standardized payment amounts (national average costs per Medicare case) for inpatient services provided by urban and rural hospitals. The urban standardized amount was 25.3 percent greater than the rural standardized amount. This variation in payment was challenged by rural health ...
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