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- Hosp Case Manag. 2015 Jul 1;23(7):92-4.
AbstractThe Centers for Medicare & Medicaid Services' (CMS') 2016 proposed rule for the Inpatient Prospective Payment System (IPPS) continues to shift the Medicare program to reimbursing providers based on quality metrics. CMS continues to raise the bar for hospitals by adding new metrics to Value-Based Purchasing, the Hospital Readmission Reduction program, and the Hospital-Acquired Condition Reduction program. Case managers should continue to educate physicians on the effect that the quality metrics have on the hospital bottom line and work with the multidisciplinary team to ensure that patients get the care they need in a timely manner and that documentation reflects the patient's condition and services received. In the proposed rule, CMS announced that it is considering feedback it has received on the two-midnight rule and will include a further discussion of the issue in the Outpatient Prospective Payment System final rule.
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