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A hospital’s wage index is an important component of Medicare facility reimbursement. Hospitals have significant flexibility to reclassify into different geographic areas to maximize their revenue, and with recent rule changes this can have substantial impacts on entire states. Join us for a discussion of the wage index calculations, including a case study of how one hospital in New York City was able to reclassify as “rural” and increase 2025 reimbursement in upstate New York by about 10%, after 2025 bids were submitted. We also discuss several other states with meaningful changes, including California, Florida, Illinois, and Massachusetts.
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We review the key pricing factors for the latest guidance issued by CMS for Medicare inpatient and outpatient prospective payment systems, for fiscal year 2025.