Medicare could save millions if it implements an expanded hospital transfer payment policy for early discharges to post acute care

Medicare could save millions if it implements an expanded hospital transfer payment policy for early discharges to post acute care

Collection:
Health Policy and Services Research
Contributor(s):
United States. Department of Health and Human Services. Office of Inspector General. Office of Audit Services, issuing body.
Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, October 2023
Language(s):
English
Format:
Text
Subject(s):
Financial Audit
Government Regulation
Medicare Part A -- economics
Medicare Part A -- organization & administration
Patient Transfer -- economics
Subacute Care -- economics
United States
Genre(s):
Technical Report
Abstract:
Why OIG Did This Audit. In a 2022 report, the Trustees of the Part A Hospital Insurance Trust Fund projected a Medicare Part A deficit of $7.3 billion by 2028 and urged policymakers to take timely and effective action to address this projected deficit. We performed this audit because data analysis indicated that significant cost savings could be realized for the Medicare program if CMS expanded the hospital transfer policy for discharges to postacute care (PAC). Our objective was to determine how the hospital transfer policy for discharges to PAC would financially affect Medicare and hospitals if CMS expanded the policy to include all Medicare Severity Diagnosis-Related Groups (MS-DRGs). How OIG Did This Audit. We reviewed a stratified random sample of 100 acute-care inpatient hospital claims for Medicare enrollees who were discharged early to PAC from 2017 through 2019. These claims were billed with specified MS-DRGs that are not subject to the hospital transfer policy for discharges to PAC. We calculated the savings that the Medicare program would have realized if the hospital transfer payment policy for discharges to PAC had been expanded to include all MS-DRGs. In addition, we compared the payments that would have been made under an expanded transfer policy with the hospitals’ calculated costs to provide care.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)
Extent:
1 online resource (1 PDF file (16 pages))
NLM Unique ID:
9918750683306676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918750683306676