What adjustment does CMS make to MS-DRG payments regarding conditions acquired during the hospital stay?

CMS makes an adjustment to MS-DRG payments based on POA (Present on Admission) indicators to properly categorize and reimburse for conditions acquired during a hospital stay. The purpose of the POA indicators is to distinguish between conditions that are present at the time of admission versus those that develop during the admission. If a condition is deemed to have been acquired in the hospital, the payment can be adjusted to reflect this change in the patient's status, as it may indicate a higher level of care, additional resources required, or longer lengths of stay.

This adjustment helps ensure that hospitals are incentivized to provide high-quality care and are held accountable for conditions that arise during hospital stays, promoting patient safety and quality assurance. By using the POA indicators, CMS can better assess the severity and complexity of cases, leading to a more accurate reimbursement process that aligns with the services provided.