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1 1 (March 25, 2022)

handle is hein.crs/govegap0001 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) HI ELIGIBILITY CRITERIA ADJUSTED PAYMENT NO. of HOSPITALS AK HI Medicare-Dependent Hospital (MDH) AK WA MT ND MN ID WY SD OR NV CO NE CA AZ UT NM Meets ONE of the following FOUR criteria: o >35 miles from another IPPS hospital O 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 O Rural and 45 minute drive to nearest other hospital Meets ALL of the following criteria: o Rural 1 'heds 0 60% are Medicare patients MDH willexpire effective October , 2022, if Congress does not extend the program. Low-Volume Hospital (LVH) AK The of the following: IPPS FY82 FY87 FY96 FY06 rate Hospital-specific rate appIcable referenceyear FY -FiscalYear 453 14% IPPSmte J75% the difference betweenthe highest histrc nst and the IPP rate IPPS FY82 FY87 FY92 rate Hospital-specific rate 5%0/' applicable rference years 25% Meets ALL of the following criteria: > 5 miles from another IPPS hospital O <3,800 annual total discharges LVH eligibility criteria are scheduled to change on October 1, 2022, ifCongress does not extend the current criteria. 1-500 Annual patient 3,800+ discharges = IPPS + (IPPS x Applicable %) 621 19%, 'Hospital-specific rate (HSR):A per discharge payment based on a hospital's average operating costs torurnishing inpatient services to Medicare benefciaries.In contrastIPPS is a per discharge payrnent based on the national average operating cost otf urnishing inpatient services to Medicare benefiiaries Both HSR and IPPS use coststrom statutoriy defined reference years, trended forward. Designations: Mutuallyexclasiv Nor mutually exrclusive n P sts: 3,228 (Excludes hospitas ins Marylnd; they are exem ptroi theIPPSl 'Class ranges display only discrete values found itn the data. Sources: CR5 analysis of relevant statute, regulations, and Centers ftr Medicare & Medicaid Services ICMiS. Medicare Program Hospital Inpatient Prospective Payment Systerns fr Acute Care Hospitals and the Long- Term Care Hospital Prospective Payment System and Final Policy Changes and Fiscal Year 2021 Rates: Quality Reporting and Medicar e and Medicaid Promoting Interoperability Proorams Requirements for Eligible Hospitals and Critical Access Hospitals 5 Federaitegis rer 58432, September 18 2020. CAH data as of October 2020 provided by the Flex Monitorng Team-an academic consortium-funded by the Federal Office of Rural Health Policy. Information prepared by Marco Villagrana, Analyst in Health Care Finanng, Paul Romero, Research Assistant, Domestic Social Policy, Mari Lee, Visual Information Spec S ,ialist and Calvin DeSouza, Geospatial informatin S-ystem sr Aa Iyst

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