Inpatient Psychiatric Facilities (IPF) payment updates
IPF Quality Reporting updates
Release Date: July 30, 2019
Federal Register Publication Date: August 6, 2019
Effective Date: October 1, 2019
Major provisions
| Update factors |
Proposed |
Final |
| Market basket update |
3.10% |
2.9% |
| Economy wide productivity adjustment |
(0.50%) |
(0.40%) |
| ACA required adjustment |
(0.75%) |
(0.75%) |
| Net market basket update |
1.85% |
1.75% |
| Impact of outlier threshold adjustment |
(0.15%) |
(0.23%) |
| Increase factor |
1.70% |
1.52% |
CMS estimates that FY 2020 total IPF payments will increase by $65 million in comparison to FY 2019. The PPS (Prospective Payment System) per diem base rate will increase from $782.78 to $798.55 ($803.48 Proposed) from FY 2019 to FY 2020, respectively. The FY 2020 per diem base rate will be reduced by 2% to $782.85 ($787.80 Proposed) for IPFs that failed to report quality data.
Market basket rebasing
The FY 2020 proposed rule also proposes revising the IPF market basket to reflect a 2016 base year (from 2012) in order to be more reflective of current data on IPF cost structures. The base year was last adjusted in FY 2016 when a 2012-based IPF-specific market-basket was adopted.
Elimination of wage index lag
The final rule (a) eliminates the 1-year lag in wage index data and (b) aligns IPF wage index data with the concurrent IPPS wage data by removing the 1-year lag of the pre-floor, pre-reclassified IPPS hospital wage index upon which the IPF wage is based.
IPF Quality Reporting Program
As proposed CMS is adopting for FY 2020 one new claims-based measure which would impact payment determinations beginning with FY 2021 and subsequent years. The added measure is Medication Continuation Following Inpatient Psychiatric Discharge (National Quality Forum #3205). This measure evaluates whether patients admitted to IPFs with certain diagnosis (Major Depressive Disorder, schizophrenia, bipolar disorder) filled at least one evidence-based medication either two days prior to discharge or during the 30-day post-discharge window.
If you are interested in more information regarding the final FY 2020 changes to the IPF, please contact Andy Majka.
Source: Medicare Program; FY 2020 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2019 (FY 2020) (Federal Register, Doc. 2019-16370 / Tuesday, August 6, 2019).
Skip to Main Content