Prospective Payment Systems

Predetermined, fixed payments in prospective payment systems (PPS) pose numerous challenges for health care providers. BKD Health Care Group can help you get paid appropriately and compliantly by Medicare for services you provide, based on the classification system of that service. Our experience working with PPS includes acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities and more.

Contact BKD to help make sense of PPS and get the reimbursement you’re entitled to.

What You Need to Know About Prospective Payment Systems

• Inpatient Prospective Payment System for Acute Care Hospitals (IPPS)

  CMS issued the proposed inpatient prospective payment system (IPPS) for federal fiscal year 2009 in the April 30, 2008, Federal Register. The proposed rule projects a 3% base payment increase for inpatient payments, and CMS plans to reduce the base rate by 0.9% to offset what it expects will be improved coding during the second year of the transition to MS-DRGs.

  BKD Feature Article

  FY2009 inpatient proposed rule
  Proposed Impact
  Proposed MS-DRG Weights

• Home Health Agencies Prospective Payment System (HHA PPS)

  In the August 22, 2007, Federal Register, CMS passes the most significant changes to the HHA PPS since 2000.

  BKD Feature Article

  CMS Passes Home Health PPS Refinements

  FREE - Home Care Information Network’s Success Strategies for a New PPS Era – Free 50-minute webcast includes overview of proposed PPS refinements by Mark Sharp, BKD Health Care Group.

  Proposed Changes to OASIS Assessment due to Proposed PPS Refinements

  Final HH PPS Rule

  CMS Home Health Agency (HHA) Center

• Outpatient Prospective Payment System (OPPS)

  CMS publishes 2008 OPPS proposed rule with final rule expected in early November and publishes ASC final rule.

  BKD Feature Article

  CMS proposed (OPPS) rule

• Inpatient Rehab & Psych PPS

BKD Health Care Group advisors also can help your facility with the following prospective payment systems:

• Skilled Nursing Facilities (SNF PPS)

• Long-term Care Hospitals (LTCH PPS)

For More Information