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Statement on FY 2018 Inpatient Prospective Payment System Proposed Rule


Statement attributable to:
Bruce Siegel, MD, MPH
President and CEO
America’s Essential Hospitals

WASHINGTON — Today’s Inpatient Prospective Payment System proposed rule is a welcome first step toward broader recognition in federal health policy of challenges that affect the health of vulnerable patients.

The rule’s Hospital Readmissions Reduction Program (HRRP) provisions will begin to level the playing field for essential hospitals as they serve low-income and other disadvantaged Americans. We are pleased to see these provisions of the 21st Century Cures Act in the rulemaking process.

But the rule is only the first step toward true risk adjustment for our patients’ social and economic challenges. We must go beyond adjusting only payments to adjusting measures so quality comparisons are fair. We also hope the Centers for Medicare & Medicaid Services (CMS) extends this approach to other quality programs, when the evidence for risk adjustment is compelling. We look forward to reviewing the proposed methodology and working with CMS to identify unintended consequences and reduce needless red tape.

We also are encouraged the proposed rule would increase uncompensated care-based Medicare disproportionate share hospital (DSH) payments in fiscal year 2018. This is a welcome change, as essential hospitals still provide high levels of uncompensated care, even with improved coverage nationally under the Affordable Care Act. We look forward to evaluating and commenting on the agency’s use of a new data source for calculating the national uninsured level and the amount of uncompensated care-based DSH payments.

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About America’s Essential Hospitals
America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

Our nearly 300 members are vital to their communities, providing primary care through trauma care, disaster response, health professional training, research, public health programs, and other services. They innovate and adapt to lead the broader health care community toward more effective and efficient care.

Carl Graziano


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