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All 32 Oregon hospitals eligible for Medicare PPS reimbursement satisfied federal quality reporting criteria and will receive the full 2% increase in 2008 for their Medicare patient services.
The Centers for Medicare and Medicaid Services (CMS) pays a majority of America’s hospitals for Medicare beneficiary health services through the federal prospective payment system (PPS), a lump sum per case called Diagnostic Related Group. DRG payments consider principal diagnosis, type of surgical procedure, complications and other criteria.
The CMS prospective payment system also includes quality measures for specific aspects of care. Hospitals must submit quality information annually to qualify for a full market basket update for the next fiscal year. Those measures cover heart attack, heart failure, pneumonia, surgical care improvement, and patient perceptions.
Critical Access Hospitals of which there are 25 in Oregon, receive cost-based reimbursement for patient care services and are not required to report the PPS quality indicators.
Twenty-one of the state’s 25 critical access hospitals report quality scores even though there is no financial incentive.
Oregon hospitals care about providing high quality services and demonstrate their commitment by voluntarily reporting quality scores to the federal government. Visit the OAHHS quality website at www.orhospitalquality.org to view the Oregon hospital reporting information and much more.
Oregon can be proud of its hospitals’ quality reporting and transparency activities; some states have many hospitals that do not participate in the Hospital Compare program.
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