Volume Decrease Adjustment (VDA) Reimbursement
At Reimbursement Recovery Partners, we help hospitals secure critical reimbursements when facing significant declines in patient volume. The Volume Decrease Adjustment (VDA) provides a vital Medicare lump sum payment for Sole Community Hospitals (SCH) and Medicare Dependent Hospitals (MDH) that experience more than a 5% drop in discharges due to factors beyond their control. In today’s unpredictable environment—shaped by seismic shifts in healthcare, persistent inflation, and a labor market that’s still settling into a new normal—accessing VDA reimbursement is more important than ever.
Volume Decrease Adjustment (VDA) Reimbursement
At Reimbursement Recovery Partners, we help hospitals secure critical reimbursements when facing significant declines in patient volume. The Volume Decrease Adjustment (VDA) provides a vital Medicare lump sum payment for Sole Community Hospitals (SCH) and Medicare Dependent Hospitals (MDH) that experience more than a 5% drop in discharges due to factors beyond their control. In today’s unpredictable environment—shaped by seismic shifts in healthcare, persistent inflation, and a labor market that’s still settling into a new normal—accessing VDA reimbursement is more important than ever.
Our People-Centric Approach
We believe people are the heartbeat of healthcare. Our approach to VDA reimbursement centers around supporting your team, easing the burden of complex applications while maximizing your financial recovery.
Collaborative Partnership
We work closely with your CFOs, Reimbursement Directors, and Revenue Cycle Teams, tailoring our approach to your hospital’s unique challenges.
Empathy and Understanding
We listen to your story, recognizing the dedication of your staff in facing difficult circumstances.
Personalized Support
Our team becomes an extension of yours, handling the intricacies of the VDA process.
Recent VDA Calculation Changes: A Win for Hospitals
The Federal Fiscal Year 2018 IPPS final rule brought significant changes to how the VDA is calculated for cost reporting periods starting on or after October 1, 2017. These changes are designed to make it easier and more advantageous for hospitals to receive VDA payments, potentially leading to substantial financial relief.
Key Changes Include:
Improved Revenue Comparison
- Previous Method: MACs compared total MS-DRG revenue to fixed costs, overlooking MS-DRG reimbursement for variable, semi-fixed, and fixed costs.
- New Method: MACs now compare only the Medicare revenue allocated to fixed costs against the hospital’s fixed costs for the period of volume decrease, offering a more accurate assessment of financial need.
Elimination of the VDA Cap
- Previous Method: A cap limited the VDA payment to the difference between total MS-DRG payments and adjusted costs.
- New Method: The cap has been eliminated, allowing for higher potential adjustment payments.
Simplified Lump Sum Calculation
- MACs now determine a lump sum adjustment based on the difference between the hospital’s fixed Medicare inpatient operating costs and its total MS-DRG revenue, simplifying the reimbursement process.
Removal of the Staffing Adjustment Requirement
- Hospitals no longer need to demonstrate explicit staffing adjustments in inpatient areas due to the volume decrease. MACs no longer account for excess staffing, simplifying both the process and administrative burden.
Why Choose Our VDA Support?
Expertise in New Regulations
We stay up to date on the latest changes and know how to use them to your advantage.
Maximized Reimbursement
Our comprehensive analysis ensures that you recover the maximum amount you’re entitled to.
Reduced Administrative Burden
We handle the complex application process, so you can focus on core priorities.