Provider Roundtable Formed in 2003

CMS has often said it wants more comments from providers as it develops the annual Medicare rule. Providers’ comments about the day-to-day operational issues that hospitals face are unique and powerful, and could result in significant improvements to the OPPS system. While many people working in the OPPS/APC field would like to share their concerns with CMS, hospital staff face enormous constraints in terms of both time and resources. These key stakeholders often are unable to share their experiences and suggestions with CMS, or are unsure how to do so. 

Nimitt Consulting realized providers needed support and encouragement in order to communicate more often with CMS. So, in 2003, Nimitt Consulting created the Provider Roundtable with the support of 3M HIS, and HCPro. 

The Provider Roundtable is a forum that gives professionals both the time and resources they need to communicate with CMS on critical issues. The Provider Roundtable brings together a nation-wide group of hospital representatives who are implementing and managing OPPS and APCs in a variety of settings. These professionals deal with OPPS and APCs every day, and have important information to share with CMS. 

Who Serves on the Provider Roundtable?

Representatives of the Provider Roundtable work in the APC/OPPS environment every day. They come from health information management, business offices, patient accounting, clinical and ancillary departments, information systems, and finance.

The Roundtable brings these experienced individuals together with Sponsors from the consulting, software, and publishing efforts on OPPS/APC. The result will be a unique exchange of information, ideas, and pertinent comments for CMS. The Roundtable provides an opportunity for peers from across the country to work together and share experiences around OPPS and APC issues. Most importantly, the process will help CMS shape the OPPS and APC system and improve it in the future.

In August 2005, the PRT welcomed four new members. A call for new applicants went out in spring 2007 and new members will be announced by August 2007. The next call for applicants will likely be in late 2008 or early 2009. If you work in the APC/OPPS environment and would like to learn more about being part of the Roundtable, please contact us at jugna@nimitt.com. We’ll let you know about opportunities to submit an application. 

• Downloadable list of PRT members and their affiliations as of June, 2007
  PDF document, 11K
• Member photos

What is the Provider Roundtable?

The Provider Roundtable is an ambitious project sponsored by Nimitt Consulting, 3M Health Information Systems (HIS), and HCPro, Inc. The forum unites hospital representatives implementing and managing OPPS and APCs across the country. The voices of front-line professionals who are dealing with OPPS and APCs should be the loudest when CMS makes changes to the system. Yet, because hospital staff face enormous constraints in terms of time and resources, these key stakeholders often aren’t able to share their experiences and suggestions with CMS.

In response to the many professionals who want to give feedback to CMS about ways to improve OPPS/APCS, Nimitt Consulting Inc. created the Provider Roundtable in 2003. This ambitious project, also sponsored by HCPro and 3M Health Information Systems (HIS), creates a forum to unite the voices of hospital representatives involved in implementing and managing OPPS and APCs across the country. This forum enables the provider community to come together as a group and speak to CMS on critical OPPS and APC issues through written comments and oral testimony.

What has the Provider Roundtable done? 

The Provider Roundtable has submitted comments to CMS on the proposed 2004, 2005, 2006 and 2007 OPPS rules. The group meets face-to-face to draft positions on the rule and submits detailed comments on numerous issues raised in the rule. CMS has listened to the PRT over the past several years, and members hope CMS will listen again for 2008. Over the past several years the PRT has also testified before the APC Advisory Panel on issues such as the separately payable observation APC, packaging, packaged revenue codes, the inpatient-only list, drug administration, and others.

To read more about the Provider Roundtable’s activities, see below.

• Provider Roundtable’s Comments on the 2007 proposed OPPS rule  PDF document, 346K

• Provider Roundtable’s Comments on the 2006 proposed OPPS rule PDF document, 60K
  • Provider Roundtable Members (as of June, 2007) 
    PDF document, 10k
• Provider Roundtable’s Comments on the 2005 proposed OPPS rule PDF document, 367K
  • Appendix A: Provider Roundtable Members 
    PDF document, 20k
• Provider Roundtable’s Comments on the 2004 proposed OPPS rule PDF document, 178K
  • Appendix A: Provider Roundtable Members
    PDF document, 56K
  • Appendix B: Per-Unit Blood Costs
    Excel (XLS) document, 28K
  • Appendix C: Modifications Submitted by Members of the Provider Roundtable
    PDF document, 194K
• HCPRO article on the 2003 Provider Roundtable comments and results