Healthy Outcomes: Final Medicare hospital inpatient prospective payment system (IPPS) and proposed outpatient prospective payment system (OPPS) changes for fiscal year 2024

On this episode of Healthy Outcomes, our host Mark Ross interviews Baker Tilly’s Keith Hutcheson, Principal, and Brian Restivo, Director in Baker Tilly’s acute care reimbursement practice. Together, they discuss the final rule issued by the Centers for Medicare & Medicaid Services (CMS) for the federal fiscal year (FY) 2024 related to the hospital inpatient prospective payment system (IPPS) which will become effective Oct. 1, 2023. In addition, they discuss the proposed outpatient prospective payment system (OPPS) rule which will become effective Jan. 1, 2024.  

Topics of discussion include:  

• A comparison between the FY 2023 and FY 2024 IPPS final rule. 
• The concept of budget neutrality in Medicare’s rate setting process. 
• The most significant issues impacting wage index for FY 2024.  
• Highlights from the FY 2024 proposed OPPS rule. 
• The 340B settlement payments to be paid to 340B eligible providers for the period 2018-2022, and how these settlement payments will impact outpatient rates being paid to non-340B eligible providers.    
• Price transparency and proposed changes in requirements and related enforcement activities.

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Brian Restivo, MBA, CHFP 

Brian is a director in Baker Tilly’s healthcare practice. With more than 14 years of industry experience in governmental reimbursement for three large integrated health systems, Brian brings significant provider-based experience to Baker Tilly’s healthcare clients. Prior to joining Baker Tilly, Brian served as Director of Revenue and Reimbursement at OhioHealth.