Posted by Kelly Sauders, Partner, Deloitte & Touche LLP
The issue of short inpatient stays is probably the biggest Medicare challenge that hospitals currently face. This issue has been an ongoing challenge for years, but until now many hospitals didn’t know how to tackle it ¬ or didn’t think they had to. That all changed on October 1, 2013, when the Centers for Medicare & Medicaid Services’ (CMS) new ‘2 midnight rule’ went into effect. Now, it’s clear that a hospital stay must include two midnights in order for associated services to be classified as inpatient. This rule change has tremendous financial and operational implications and should be addressed immediately. Hospitals that continue to ignore the problem are at significant risk of facing more and more Medicare denials. Here are five steps hospitals can consider taking to help address this risk:
Medicare enforcement related to short stays has escalated; meanwhile, other payers are starting to focus on this area in order to reduce costs and improve quality. Every day that healthcare providers wait to tackle this issue exposes them to increasing financial and compliance risks. Hospitals should take steps now to address this challenge, so they can continue to provide quality, cost effective care in the right setting — and increase their chances of being appropriately reimbursed.