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- Hosp Case Manag. 2012 Oct 1;20(10):150-1.
AbstractThe Centers for Medicare & Medicaid Services' (CMS) Inpatient Prospective Payment System final rule for 2013 makes it clear that in the future, hospital reimbursement is going to hinge even more on the quality of care patients receive. CMS announced its intentions to add more risk-adjusted measures to the reimbursement reduction and value-based purchasing initiatives in future years, penalizing hospitals that do not do as well as their peers on these measures. Case managers must make sure that patients are in the appropriate level of care and that documentation clearly reflects how sick patients are and the care they receive. Even though some measures won't be added to value-based purchasing until fiscal 2015, the performance period starts as early as Oct. 1, 2012, making it imperative for hospitals to make improvements now.
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