Inpatient Prospective Payment System (IPPS)

Inpatient Prospective Payment System (IPPS)

Under Medicare Part A, payment for acute care hospital inpatient stays is based on set rates. This system for payment– the inpatient prospective payment system (IPPS)–categorizes cases into diagnosis-related groups (DRGs) which are then weighted based on resources used to treat Medicare beneficiaries in those groups. Important for safety net providers, hospitals that treat a large share of low-income patients receive additional add-on payment in the form of a disproportionate share hospital (DSH) adjustment. Teaching hospitals also receive additional add-on payments, which are based on resident to average daily census ratios. The IPPS rule is updated annually, with comment periods open prior to implementation of the final rule.

Inside Medicare

More...

Explore similar topics
Safety Net Financing
Medicare
"IPPS, Inpatient Prospective Payment System

Resources for this section

America's Essential Hospitals FY 2014 IPPS Proposed Rule Comment Letter
Comments on Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2014 Rates. This rule includes provisions related to the Affordable Care Act's Medicare DSH payment cuts.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2014 Rates – Proposed Rule (August 2013)
Copy of the final rule, published in August 2013. This rule includes provisions related to the Affordable Care Act’s Medicare DSH payment cuts.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2014 Rates – Proposed Rule (April 2013)
Copy of proposed changes, published April 2013. This rule includes provisions related to the Affordable Care Act’s Medicare DSH payment cuts.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates – Final Rule
Copy of Final Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates. Published October 2012. This rule includes provisions related to readmissions.

NAPH FY 2013 IPPS Proposed Rule Comment Letter
Comments on Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates. This rule includes provisions related to readmissions.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates – Proposed Rule
Copy of Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates. Published April 2012. This rule includes provisions related to readmissions.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates – Final Rule
Copy of Final Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates. Published August 2011. This rule includes provisions related to readmissions.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates – Proposed Rule
Copy of Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates. Published April 2011. This rule includes provisions related to readmissions.

NAPH FY 2012 IPPS Proposed Rule Comment Letter
Comments on Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates. This letter also includes comments on the proposed regulations regarding readmissions.

Upcoming Events

View Full Calendar

Medicaid Payments to Incentivize Delivery System Reform
12/17/2013-12/17/2013

HCAHPS: Patient Experience College – Everything You Need to Know to Participate
12/18/2013-12/18/2013

Policy Assembly: Take Action
4/1/2014-4/2/2014
Washington, D.C.

Vital2014
06/25/2014-06/27/2014
San Antonio, Texas

From:
Email:
To:
Email:
Subject:
Message: