WSHA Provides Analyses of Medicare Inpatient PPS Rule

June 13, 2018

Last week, WSHA sent hospital-specific analyses of the final Medicare Inpatient Prospective Payment System (IPPS) rule to the chief financial officer or other designated recipient at each of our member Prospective Payment System (PPS) hospitals. The analysis estimates how Medicare inpatient fee-for-service payments will change from FFY 2018 to FFY 2019 based on the policies in the FFY 2019 proposed rule. The analysis compares the year-over-year change in operating, capital, and uncompensated care IPPS payments and includes breakout sections that provide detailed insight into specific policies that influence IPPS payment changes.

Washington State PPS hospitals will receive an average increase in hospital inpatient rates of 2.1 percent, though the rate varies among hospitals, from a positive 5.5 percent to a negative 7.5 percent. These rates do not include the additional 2 percent sequestration reduction authorized by Congress through FFY 2027. On a national basis, the proposed rule provides a marketbasket increase in hospital inpatient rates of 2.7 percent, which is partially offset by mandated productivity and coding related reductions and adjustments. It also includes changes relating to calculation of wage index, and changes to Medicare DSH payment calculation as CMS transitions to greater use of Cost Report S-10 information. The proposed rule also requires that, effective January 1, 2019, hospitals post online in a machine-readable format their standard charges, which could be the chargemaster or another form of the hospital’s choice. CMS is seeking public comment on how to define “standard charges” and what form of the information would be most beneficial to patients.

If you have comments or questions about the data, please contact Seva Kumar at or Andrew Busz at


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