OBJECTIVES

At the completion of this program, participants will be able to:

1. Describe the difference between the current Medicare cost-based (TEFRA) reimbursement system and the “prospective payment system” (PPS) for Medicare recipients receiving inpatient psychiatric care. [Note: The final rule appears in the November 15, 2004, Federal Register.]
2. Identify the proposed components of the inpatient psychiatric PPS as outlined in the final rule.
3. Identify questions to help evaluate your hospital’s current financial and clinical operations so that you can identify appropriate changes needed to address the new payment system.
4. Discuss issues related to the needs of various patient populations (age, severity of impairment, length of stay, etc.) as they are reflected in the final PPS rule.
5. Discuss ways to improve the efficiency and lower the costs of your clinical programming.
6. List steps to be taken to prepare the facility for the move to inpatient psychiatric PPS.