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March 27, 2018


Spring OPPS Update Released

The Centers for Medicare and Medicaid Services (CMS) summarized the spring update to the outpatie... Learn More


Therapy Caps Repealed and Payment for Therapy Assistant Services Lowered

Medicare payment caps on outpatient therapy were permanently repealed effective January 1, 2018. ... Learn More


OIG Update Work Plan, Studies Cardiac Device Credits

In March, the Office of Inspector General (OIG) posted several updates to its existing Work Plan,... Learn More


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Medical Coding News Archives

ACE Demonstration Project Launched

 
February 12, 2008:
A demonstration project starting up this October will dramatically change the way providers in the project will be paid. The Acute Care Episode (ACE) Demonstration is specifically designed to align incentives and provide flexibility to hospitals and physicians by bundling all related services into an “episode of care.” A single, global payment then will be used as the providers of care deem most appropriate.

The Centers for Medicare and Medicaid Services (CMS) states that the “goal of the demonstration is to align hospitals’ and physicians’ incentives to work together to provide coordinated, cost effective care, thus achieving savings to the Medicare program and giving hospitals and physicians the flexibility to allocate resources as they determine is the most appropriate.”

The agency will select approximately 15 sites to participate in this demonstration, which is projected to begin on or after October 1, 2008. Sites will be selected from among states that pay claims under the diagnosis-related group (DRG) inpatient prospective payment system. Individual demonstration projects sites will continue for three years from their first date of operation, although CMS will have the option to extend them and/or add additional demonstration sites.

There are two categories of DRGs; if a demonstration site is selected for a particular category of DRGs, all Medicare admissions to the facility for DRGs in that category will be processed under the demonstration payment rules. CMS staff will provide contractors with a list of all demonstration providers and their associated identification numbers (e.g., NPI, Medicare legacy provider identification number, etc.) as well as DRGs covered under the demonstration for each facility.

Deborah C. Hall
Clinical/Technical Editor

 

 
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