CMS proposes 1.7% payment hike for inpatient rehabilitation facilities

Proposal also means 19 hospitals now listed as rural would be converted to urban, losing their 14.9 percent payment adjustment.

The Centers for Medicare and Medicaid Service on Thursday proposed increasing payment to inpatient rehabilitation hospitals by $130 million, or 1.7 percent, in 2016, according to its proposed prospective payment rate.

The increase would come with new quality reporting requirements for these hospitals that provide long-term acute care for patients dealing with debilitating injuries. There are more than 1,000 inpatient rehabilitation hospitals in the United States.

CMS also said it has finished aligning new ICD-10 codes with its payment systems, and it reiterated that ICD-10 will be the required code set for all Medicare claims as of Oct. 1.

[Also: Takeaways from the proposed 2016 IPPS rule]

The agency also proposed revising its wage index for 2016 to comply with new delineations between major and smaller metropolitan areas. Unfortunately, that means 19 hospitals now listed as rural would be converted to urban, losing their 14.9 percent payment adjustment. CMS said it would soften the blow by stretching that payment adjustment over three years.

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While inpatient hospital can expect payment increases in 2016 if this rule passes, like most other areas in healthcare that are transitioning from fee-for-service, facilities will see their payments tied to quality reporting requirements. Inpatient hospitals, much like long-term care hospitals and skilled nursing facilities, will have to submit data in three quality measures: skin integrity and changes in skin integrity; functional status, cognitive function, and changes in function and cognitive function; and incidence of major falls.

CMS is expected to publish quality data on these facilities in the fall.

Here is the full proposal, from CMS:

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