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1 1 (March 23, 2022)

handle is hein.crs/goveflp0001 and id is 1 raw text is: Medicare Hospital Payment A predetermined, fixed, per discharge payment for inpatient services furnished to Medicare beneficiaries, subject to adjustments. HOSPITAL DESIGNATION LOCATIONS f Sole Community Hospital (SCH) ME AK HI Su .VT NH TA M ND MN WI MI MA RI ID WY SD 1A IL IN PA NJ C OR N': CO NE WV MD DE CA Ai UT KS AR VA NC 0 N LA SC1-6 ~A7-it 17- F 28- S43- ELIGIBILITY CRITERIA Meets ONE ofthe following FOUR criteria: 0>35 miles from another IPPS hospital S Rural and 25-35 miles from another hospital and * Is the exclusive hospital provider in the area, or - <50 beds, meets exclusive hospital provider criterion but for patient transfers to other hospitals for specialized care o Rural and 15-25 miles from a hospital that is inaccessible 0 Rural and 45 minute drive to nearest other hospital ADJUSTED PAYMENT The of the following: IPPS FY82 FY87 FY96 FY06 rate Hospital-specific rate appicable reference years Fy -Fiscalyear DC 27 42 st NO. of HOSPITALS 459 Meets ALL of the following criteria: 0Rural Os 100 beds o Notan SCH O 60%are Medicarepatients MDH will expire effective October 1, 2022, if Congress does not extend the program. I'1b18 IPPsrale 75%0 1 0 +. difference between the ,fi r h i shstoic cstandthe IPPS FY82 FY87 FY92 rate .. , Hospital -specific rate F% applcab referenc years' Meets ALL of the following criteria: 0>15 miles from another IPPS hospital <3,800 annual total discharges LIH eligibility criteria are scheduled to change on October 1,2022, if Congress does notextend the current criteria. 25% 615 00 1-500 Annual patient 3,800+ discharges = IPPS + (IPPS x Applicable %) 'Hospital-specific rate (HSR): A per discsharge payment based on a hospitats average operating costs forfurnishing inpatient services to Medicare beneficiaries.ln contrast IPPS is a per discharge payment based on the national average operating cost of furnishing inpatient services to Medicare beneficiaries. Both HSR and IPPS use costs from statutorily defired reference years, trended forward. Designations: _ Mutuallayexcfsni Not ruRinly exsive *TofalnumberofliPPShospitas:3,222 (Exludes hospitals in Marylard; they are exempt from the IPPS) 'Class ranges &splryonlydiscrere values foundin the data. Sources: CRS analysis of relevant statute regulations, and Centers for Medicare & Medicaid Services, Medicare Program Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates; Quality Programs and Medicare Promoting Interoperabii ty Prograr Requirements for Eligible Hospitals and Critical Access Hospitals; Changes to Medicaid Provider Enrollment; and Changes to the Medicare Shared savings Program7 86 FederaRegister 44774, August 13, 2021. CAH data as of November 2021 provided by the Flex Monitoring Team-an academic consortium-funded by the Federal Office of Rural Health Policy. 1nfIrmation prepared by Marco Villagrana, Analyst in Health Care Financing, Paul Romero, Research Assistant, Domestic Social Policy, Man Lee, Visual information Specialist and Calvin DeSouza C RS Geospatial Information Systems Analyst. Medicare-Dependent Hospital (MDH) AK WA MT ND ID WY SD OR NV CO CA AZ UT NM HI Low-Volume Hospital (LVH) AK

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