Skip Page Banner  
HEALTH CARE
BLOG

Thursday, May 23, 2013

Is Congress Undermining The IPPS? GAO Thinks So.

by Nathaniel Weixel

RSS

Congress meant well. In 1983, they created the hospital inpatient prospective payment system to help control the growth of hospital spending; give hospitals an incentive to provide care efficiently; and ensure beneficiary access to care. Good ideas, in theory. But in practice, they also left themselves the option of making legislative modifications to the IPPS, changing the way some hospitals are reimbursed.

These modifications were only supposed to be made for a small subset of hospitals. But that hasn’t been the case, and now a report from the Government Accountability Office -- Legislative Modifications Have Resulted in Payment Adjustments for Most Hospitals -- finds that 30 years later, nearly all hospitals paid under the IPPS system qualified for an adjustment or exemption because of a congressional modification. Many of those hospitals even qualified for multiple categories of payment adjustments.

Both the Institute of Medicine and the Medicare Payment Advisory Commission have said that congressional modifications undermine the IPPS's integrity, and GAO’s report agreed. The report concluded that the way Medicare currently pays hospitals may no longer ensure that the goals of the IPPS-- cost control, efficiency, and access—are being met.
Subscription RequiredAll BNA publications are subscription-based and require an account. If you are a subscriber to the BNA publication and signed-in, you will automatically have access to the story. If you are not a subscriber, you will need to sign-up for a trial subscription.

You must Sign In or Register to post a comment.

Comments (0)