How much will CMS’s no-pay policy cost hospitals?

The hospital industry is expected to lose at least $91 million annually as a result of Medicare's no-pay policy for hospital-acquired conditions (HACs), according to a recent study.

If this number sounds surprisingly small, it might be, admits the study's authors. The initial study focused on only seven of the HACs in Medicare’s no-pay policy. In its IPPS Final Rule, CMS expanded the number of no-pay HACs 11—the new rule will take effect October 1, 2008. In addition, the $91 million figure only accounts for Medicare's non-payment of HACs. Several commercial payers have also adopted no-pay policies for HACs, which will contribute to the losses that the hospital industry will encounter.

Selected findings from the study, produced by Thomson Reuters Corp.’s healthcare business, formerly known as Solucient, were released to Modern Healthcare and published in this article.