New Rule Explains How Medicare Will Pay Under ACA

  • Originally published May 3, 2013 , last updated June 4, 2015
  • Medicare

Medicare recently released a 1,424-page rule telling Medicare hospitals what they will get paid in 2014. Next year, hospitals will see a 0.8 percent payment increase, or about $27 million more than in 2013. This is a significant increase, considering that in 2012 Medicare costs grew at half that rate.

What’s noteworthy about this announcement is that it carries out the Affordable Care Act provision that says 2 percent of reimbursements will depend on how well the hospitals prevent readmissions. Medicare is increasing the payments to the very best hospitals, but poor performing hospitals will get reimbursed less. Medicare will now penalize hospitals for patients who are readmitted due to knee or hip replacements. How does this affect your clients? The impact of these types of payments could drive some vulnerable hospitals out of business, since these safety-net hospitals see the most low-income and uninsured Americans. A 2 percent cut in Medicare reimbursements could make a significant difference.

For more information on this rule and the Affordable Care Act, read this article posted by The Washington Post.