ABSTRACT
As the healthcare industry continues to struggle with an ever-evolving APC-based hospital outpatient PPS, it's important to be aware of some of the latest changes affecting providers and to recognize areas that may present particular challenges for private payers.
Subject(s)
Ambulatory Care/economics , Medicare/organization & administration , Prospective Payment System/organization & administration , Outliers, DRG , Reimbursement Mechanisms/economics , United StatesABSTRACT
As hospitals near the end of their third year with APCs and the Medicare outpatient PPS, it's important to reflect on past successes and prepare for the management strategies that will be needed for tomorrow. Particularly important will be reinforcing the importance of interdepartmental cooperation, especially as it relates to new documentation and coding requirements, observation and emergency department protocols, E/M classifications, registration processes, and medical staff involvement.
