|
2.4 Additional Payments to High-Volume Providers
High-volume provider payments to primary care providers, specialists, and dentists end effective with dates of service beginning September 1, 2007. High-volume provider payments to outpatient hospitals and ASCs/HASCs continue.
Outpatient hospital services are those services provided by outpatient hospitals and ASCs/HASCs. The definition of a high-volume outpatient hospital provider is one that was paid a minimum of $200,000 during the qualifying period. This criterion captured about 95 percent of total outpatient hospital spending. Similar criteria were developed for ASCs/HASCs, such that providers accounting for 95 percent of total payments were designated as high-volume providers. Payments to high-volume outpatient hospitals were increased by 5.2 percent. The new payment amount was implemented by increasing the discount factor for designated high-volume providers of outpatient hospital services from 80.3 percent to 84.48 percent. ASCs/HASCs that qualify as high-volume providers also receive a 5.2 percent increase in payment rates.
|
