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Hospital Outpatient Department (HOPD) E/M Cuts - MedPAC January 2012 – MedPAC formally adopted a recommendation • “…reduce payments for evaluation and management office visits provided in outpatient departments so that total payment rates for these visits are the same in an outpatient department for physician office….” • (MedPAC Report March 2012) • Phase transition over 3 years • Limited stop loss for hospitals with DSH patient percent at or above median (@25%) • Study by 2015 to examine impact on access for low-income patients • Greatest impact on major teaching and nonprofit hospitals 2012 AAMC Annual Meeting
MedPAC Proposal 99213 - Midlevel Established Patient Visit Fees* Physician Office HOPD Differential Physician Fee $68.97 $49.27 ($19.70) Hospital Fee N/A $75.13 $19.70 Total $68.97 $124.40 $68.97 +$75.13 +$19.70 +$55.43 $0 * Fees based on national 2011 rates and include patient copay. 74% reduction to hospital payment 2012 AAMC Annual Meeting
Page 1 and 2: State of the Academic Clinical Ente
Page 3 and 4: AAMC Health Care Affairs • Suppor
Page 5 and 6: DataTrends: Hospital Margins 2012 A
Page 7 and 8: Hospital Total All-Payer Margins, b
Page 9 and 10: COTH Characteristics Short-Term, Ge
Page 11 and 12: COTH Quarterly Survey Results 2009-
Page 13 and 14: Medicare Resident Limits: Mandated
Page 15 and 16: Resident Limit Redistributions ACA
Page 17 and 18: Sec. 5506 Slots by Teaching Status
Page 19 and 20: Sec. 5506 DGME Slots by State - Fir
Page 21 and 22: 2012 AAMC Annual Meeting Readmissio
Page 23 and 24: Concern with Risk Adjustment • Ri
Page 25 and 26: Readmission Rates are Higher for Du
Page 27 and 28: Approach: Model Specification and S
Page 29 and 30: Readmission Program Impact on COTH
Page 31 and 32: Value-Based Purchasing (VBP) • Mo
Page 33 and 34: How is the VBP Money Moving? Major,
Page 35 and 36: Medicare Spending Per Beneficiary (
Page 37 and 38: Exclusions •IME and DSH payments
Page 39 and 40: MSPB National Distribution 50% Medi
Page 41 and 42: MSPB - Where Spending Occurs Breakd
Page 43: Physician Payments at HOPD For many
Page 47 and 48: Study AAMC contracted with The Mora
Page 49 and 50: Distribution of Medicare E/M Visits
Page 51 and 52: Major Teaching Hospitals Serve Prop
Page 53 and 54: High Level Findings • Proposed
Page 55 and 56: What is a bundled payment? • New
Page 57 and 58: AHA-AAMC Bundling Analysis Key Ques
Page 59 and 60: Defining the Bundle Characteristics
Page 61 and 62: Pricing the Bundle Add-on payments
Page 63 and 64: Pricing the Bundle: Add-on Payments
Page 65 and 66: Pricing the Bundle: Patient and Hos
Page 67 and 68: Managing the Bundle: Readmissions s
Page 69 and 70: Managing the Bundle: Percent of Rea
Page 71 and 72: Key Findings • Bundling is here
Page 73 and 74: Bundled Payments for Care Improveme
Page 75 and 76: AAMC Applicant Organizations • Al
Page 77 and 78: Brandeis Data Analysis Total allowe
Page 79 and 80: BPCI Lessons Learned To Date • AM
Page 81: Questions??? Additional information

Hospitals

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