The Inpatient Only Rule, Alternative Payment Models, and the Relative Value Update Committee Reimbursement and Coding Changes: What Do They Mean?

Abstract

The unsustainable rising costs of healthcare, a greater portion of which is being borne by the federal government, has resulted in the government's development of programs aimed to control costs without adversely affecting outcomes. Alternative Payment Models, the shift from inpatient to outpatient and ambulatory surgery centers' surgical venues, and Relative Value Update Committee coding and reimbursement strategies are all designed to achieve the aforementioned goal. These programs will continue to influence our practice patterns. It is clear that we must continue to advocate for access to high quality care reimbursed at a fair price. It is also clear that the successful adult reconstructive surgeon will understand these programs and adjust his/her practice to take full advantage of the opportunities that these programs present.