Who will lose under the outpatient PPS?
Who will lose under the outpatient PPS?
Half the big losers are in the West
Hospitals are under pressure to improve coding and control resource utilization in order to move from cost-based reimbursement to the new outpatient prospective payment system (PPS).
To lessen the financial impact on hospitals, the Health Care Financing Administration will implement a phase-in plan that provides additional payments that gradually decline over a three-year period. But in a joint study conducted by Market Insights and Superior Consultant Company prior to the release of the final rule on April 7, 2000, overall hospital outpatient reimbursement in year one was forecasted to decrease by 10%.
According to the study, hospitals have to take action now to alleviate the negative impact from PPS on their bottom lines. The consultants advise health care organizations to do the following:
• Perform a retrospective analysis that will apply the new rules to your historical claims data.
• Educate your staff about the new system, and encourage improved efforts in correct coding and claims processing.
• Address outpatient cost competitiveness.
[For more information on the study, or for help completing a historical analysis, contact Market Insights at (843) 406-8826.]
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