Dovetailing with my previous post on MS-DRG staff training, today’s post takes a quick look at some considerations when creating an MS-DRG implementation task force.

Implementation of MS-DRGs will require a coordinated response from many hospital departments, including administration, health information management, patient financial services, medical staff, information systems, quality improvement, and the compliance office. Hospitals must bring together the individuals who will be influential in successfully implementing MS-DRGs. Here are some steps to consider:
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Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Republican Chuck Grassley (R-Iowa) sent a letter to the Centers for Medicare & Medicaid Services (CMS) opposing the 2.4 percent "behavioral offset" cuts in the Proposed Rule.

The senators expressed concern about the impact that the cuts will have on rural hospitals. Both stated that any planned cuts should be based on actual experience, not speculation.
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The American Health Information Management Association (AHIMA) submitted its comment letter to the Centers for Medicare & Medicaid Services (CMS) on the proposed changes to the Medicare Hospital Inpatient Prospective Payment System (IPPS). AHIMA stated that a transition to MS-DRGs in FY 2008 might be premature:

"AHIMA recommends that implementation of a severity-adjusted DRG system be delayed until FY 2009, when the RAND report is final, the most appropriate severity-adjusted DRG system can be selected, and ample time exists for implementation."

In addition, AHIMA stated that it disagrees with the 2.4 percent "behavioral offset" cuts:
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Ingenix, like other organizations with a stake in MS-DRGs, submitted a letter to the Centers for Medicare and Medicaid Services (CMS) commenting on the Inpatient Prospective Payment System proposed rule for FY 2008.

In that letter, dated June 11, we voiced our support for MS-DRGs. A severity-adjusted grouper is long overdue.

We expressed our appreciation for the open and transparent manner in which CMS developed this severity-adjusted methodology. Like any system of this complexity, the DRG system will need further refinements down the road. We urged that future changes continue to be undertaken with a high degree of openness and transparency.
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October will be here before we know it, and with it, the likely arrival of MS-DRGs. But for now, the dog days of summer are nearly upon us. It’s a time when the temperatures make many of us yearn for an air conditioned place to chill out. So, take advantage of your office’s air conditioning and start setting up some MS-DRG staff training!

Successful MS-DRG implementation requires that key hospital staff understand the fundamentals of MS-DRGs. Specific topics to consider in this initial training include:
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The formal comment letter that the Medicare Payment Advisory Commission (MedPAC) submitted to CMS recommended the following reduction in the proposed “behavioral offset” rates:

“For fiscal year 2008, we recommend that [CMS] adopt an adjustment that is between -1.6 and -1.8 percent per year (for at least the two years following adoption of MS-DRGs) to the standardized amounts to offset the expected impact of improvements in documentation and reporting of diagnosis.”
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Hundreds of participants took part in several Ingenix MS-DRG Webinars that I hosted in May. In addition to the presentation, participants had the opportunity to post questions. Below are several questions and answers from the Webinars:

Q: Will CMS be prepared to implement MS-DRGs beginning October 1st?
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What CMS has termed as "behavioral offset" cuts in its IPPS Proposed Rule are being called "backdoor budget cuts" by the American Hospital Association.

In a formal comment letter sent to CMS June 4, AHA Vice President Rick Pollack said that CMS "has gone well beyond its charge by recommending arbitrary and unnecessary cuts in this proposed rule. These backdoor budget cuts will further deplete scarce resources, ultimately making hospitals' mission of caring for patients even more challenging."
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