If it's complicated, it must be the IPS
Can't understand it? You're not alone
One reason it has taken Congress and the public so long to understand the pitfalls of the new interim payment system (IPS) is the system is so complicated.
"It's hard to get a grass-roots message across when you're talking about something with such great complexity," says Theresa Forster, vice president for policy, with the National Association of Home Care (NAHC) in Washington, DC.
William A. Dombi, NAHC vice president for law, clearly outlined the purpose and effects of IPS in his testimony to the U.S. Senate's Special Committee on Aging on March 31. "The purpose of IPS was to restrain the growth in home health utilization and limit the growth in expenditures," Dombi said.
"A number of significant problems have emerged which have led to results which, NAHC believes, were unintended by Congress in putting this system in place," he said.
Dombi explained that under IPS, agencies are reimbursed the lowest of the following methods:
· actual allowable costs;
· aggregate per-visit cost limits;
· new aggregate per beneficiary limit.
In addition, IPS reduced per-visit costs in two ways:
· The limits are calculated based on 105% of the median per-visit costs of freestanding home health agencies, rather than the previous method of 112% of the mean.
· The new cost limits do not take into account the price increases that occurred between July 1, 1994, and June 30, 1996.
The IPS per-beneficiary limit is a blended limit of 75% agency-specific data and 25% census region data, using fiscal year 1994 as the base year. "Using fiscal year 1994 as a base year means using 1993 data for a substantial number of providers with the result that payments are based on five-year-old data," Dombi says. "Out-of-date payment levels do not reflect changes that have occurred in the population served by home care or the types of services agencies are providing in 1998, 1999, or beyond."
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content