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He explains the elements of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes, as well as the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare Home Health Prospective Payment System (HH-PPS), Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party paters.
This increase was due to a shift to post-acute care as a way to reduce acute care length of stay after the prospective payment system for acute care hospitals was put in place and to liberalization of the definitions of eligibility for service provision and coverage (Lewis et al.
We think that's a fair increase," said Mark Covall, executive director of the National Association of Psychiatric Health Systems, adding that this is the first increase since CMS implemented the prospective payment system for inpatient psychiatric facilities in early 2005.
The final rule for the Outpatient Prospective Payment System (OPPS) presented by the Health Care Financing Administration (HCFA), provides a unified payment system that moves the Medicare program toward a fully prospective payment, according to a new report available from the Healthcare Intelligence Network (http://www.
Veit says that providers left on the outside of Medicare+ Choice opportunities will face decreasing revenues, resulting from the freezing of hospital payments for 1998 under the DRG-based hospital prospective payment system.
Under the Prospective Payment System (PPS) implemented by Medicare in 1983, hospitals are paid a set price for each Medicare patient treated, rather than being reimbursed for the patient's costs as had been done previously.
Coming: Prospective payment system for outpatient care
Here is your chance to get an in-depth analysis of the Medicare Inpatient Prospective Payment System Fiscal Year 2011 hospital reimbursement final regulations.