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Medicare program; changes to the inpatient hospital prospective payment system and fiscal year 1987 rates--HCFA.
Abstract:
We are amending the Medicare regulations governing the inpatient hospital prospective payment system to implement necessary changes arising from legislation and our continuing experience with the system. In addition, we are describing changes in the methods, amounts, and factors necessary to determine prospective payment rates for Medicare inpatient hospital services. In general, these changes are applicable to discharges occurring on or after October 1, 1986. We are also setting forth the update factor for determining the rate-of-increase limits (target amounts) for hospitals excluded from the prospective payment system.
Insights
This update revises Medicare
Area of Science:
- Health Policy
- Healthcare Administration
- Medical Economics
Background:
- The inpatient hospital prospective payment system (PPS) requires regular updates.
- Legislative changes and operational experience necessitate adjustments to Medicare regulations.
Purpose of the Study:
- To amend Medicare regulations for the inpatient hospital prospective payment system.
- To detail changes in payment rate determination methods, amounts, and factors.
- To establish the update factor for rate-of-increase limits for excluded hospitals.
Main Methods:
- Regulatory amendment process.
- Analysis of legislative mandates.
- Incorporation of operational system experience.
Main Results:
- Implementation of revised prospective payment rates for Medicare inpatient hospital services.
- Updated factors for calculating prospective payment rates.
- Establishment of the update factor for rate-of-increase limits for excluded hospitals.
Conclusions:
- The revised Medicare regulations aim to improve the prospective payment system.
- Changes are effective for discharges on or after October 1, 1986.
- The update factor provides a mechanism for rate-of-increase limits for excluded facilities.