FY 2020 IPPS final rule: Review financial implications for hospitals

Why This Topic Matters

The final rule can change hospital reimbursement, quality-related adjustments, and reporting obligations for the upcoming fiscal year. Understanding the broad categories of change helps hospitals prepare staffing, budgeting, coding review, and compliance responses.

Article Sections

1. Financial update

   Summarizes the overall payment update and the main components that affect hospital reimbursement under the FY 2020 inpatient prospective payment system. Covers general spending impact, outlier payment context, and related value-based adjustments.

2. Wage index changes

   Reviews CMS policy changes affecting wage index methodology and related adjustments for hospitals across different geographic areas. Discusses the broader rationale and intended effects of the finalized updates.

3. New technology

   Covers updates to hospital add-on payment policy for qualifying new technologies and other related payment policy revisions. Includes the broader framework CMS uses for evaluating and financing new technology under the inpatient system.

4. New NTAP pathway for devices

   Describes a new payment pathway tied to FDA programs for certain devices and related technology applications. Also addresses the timing of when the policy begins to apply.

5. Additional revisions to the NTAP substantial clinical improvement criterion

   Summarizes CMS revisions to how it evaluates the clinical improvement standard used in technology add-on payment decisions. Focuses on regulatory clarification and the types of information CMS may consider.

6. NTAP approvals for FY 2020

   Provides an overview of the FY 2020 technology approvals and continuing add-on payment items. Explains the general relationship between inpatient billing, technology identification, and payment eligibility.

7. Changes to MS-DRGs

   Reviews CMS updates to diagnosis and procedure groupings that affect severity assignment and case mix impacts. Highlights changes to group structure and coding review considerations.

8. Disproportionate share

   Summarizes the FY 2020 disproportionate share hospital payment update and the data sources CMS uses in the formula. Covers the broader uncompensated care methodology and related hospital categories.

9. LTCH PPS changes

   Explains major long-term care hospital payment system updates, including transition-related policy changes and payment adjustment processes. Describes the general direction of the finalized LTCH policies.

10. Promoting Interoperability (aka Meaningful Use)

    Reviews updates to the hospital interoperability and EHR reporting programs. Covers measurement period changes, reporting alignment, and broader quality reporting revisions.

11. Conclusion

    Offers a brief wrap-up emphasizing the need for hospitals to prepare for the finalized policy changes. Reinforces the operational importance of reviewing reimbursement and reporting impacts.