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Capital PPS: trekking through the labyrinth.

P L Grimaldi

    Healthcare Financial Management : Journal of the Healthcare Financial Management Association
    |October 6, 1991
    PubMed
    Summary
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    The Health Care Financing Administration (HCFA) is changing Medicare inpatient capital payments with a new prospective or hold harmless system. This includes payment floors, revised outlier payments, and an exceptions process, phased in over 10 years.

    Area of Science:

    • Health economics
    • Healthcare policy
    • Medicare finance

    Background:

    • The Health Care Financing Administration (HCFA) previously had different methods for Medicare inpatient capital cost reimbursement.
    • Hospital capital costs represent a significant component of overall healthcare expenditures.

    Purpose of the Study:

    • To outline the new Medicare inpatient capital cost payment system implemented by the Health Care Financing Administration (HCFA).
    • To detail the key components of the prospective payment system and the hold harmless method.
    • To inform stakeholders about the transitional phase and exceptions within the new system.

    Main Methods:

    • The new system employs a fully prospective payment model or a hold harmless method for hospitals.
    • It incorporates a payment floor for total capital expenditures.

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  • A revised outlier payment system and an exceptions process for additional capital payments are included.

    • Main Results:

    • Hospitals will be reimbursed under one of two primary payment structures: prospective or hold harmless.
    • The system introduces financial safeguards with a payment floor and provisions for exceptional circumstances.
    • The implementation is designed as a gradual 10-year phase-in process.

    Conclusions:

    • The new HCFA payment system aims to standardize and potentially control Medicare inpatient capital costs.
    • The phased approach allows for adaptation by healthcare providers.
    • The system's components are designed to balance predictability with flexibility in capital reimbursement.