Outpatient PPS may be phased in
Outpatient PPS may be phased in
Although the Health Care Financing Admini-stration is still planning to implement an outpatient prospective payment system (PPS) by July 2000, Congress and the White House are considering several proposals for phasing in the system.
The outpatient PPS will be based on ambulatory patient classifications (APCs), initially developed by 3M Health Information Systems (3M HIS) in Salt Lake City. The inpatient PPS was phased in over five years, explains Dave Fee, product marketing manager with 3M HIS. Fee emphasizes that Congress and the White House are not trying to discontinue or delay implementation of APCs. "Phase in does not mean delay," he says.
Congress and White House representatives also are discussing how to minimize financial risk, at least initially, for outpatient programs. "If there are losses, those losses are minimized [in the proposed changes], or at least kept to a ceiling," Fee says.
Another issue is payment for drugs. "The perception is that drugs are not handled as well as they need to be, in the current preliminary regulations for APCs," he says. "There’s a desire that drugs should be handled separately, i.e. paid for separately, which they’re not currently."
If the issue is resolved legislatively, it should be resolved before Christmas, says Michael Blau, JD, at McDermott, Will, & Emery, Attorneys at Law, in Boston.
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