The Centers for Medicare & Medicaid Services (CMS) Volume Decrease Adjustment (VDA) is a financial mechanism designed to support hospitals, particularly small and rural facilities, when they experience a significant decrease in patient volume. If a hospital sees a substantial reduction in inpatient admissions due to circumstances beyond its control, the VDA provides additional payments to offset the financial loss from reduced Medicare reimbursements. The VDA is designed to help hospitals remain operational and provide services even when patient volumes unexpectedly drop.

Your hospital may be able to leverage additional reimbursement opportunities—potentially millions of dollars—to cover fixed and semi-fixed costs through VDA.

However, qualifying for a VDA is a complex process that brings significant documentation burdens. Applications submitted without proper information, or a convincing argument could be denied—and with no appeals process available, your hospital could miss out on the additional reimbursement.

Secure VDA cost savings for your hospital with guidance from our professionals helping to assess your eligibility, gather your documentation, and strategically develop summaries that will resonate with Medicare Administrative Contractors (MAC).

Secure Savings with Persuasive and Engaging Summaries

Qualifying for a VDA payment requires diligent documentation and overwhelming evidence of eligibility demonstrating your hospital experienced a decline of more than 5% of total inpatient discharges in a cost reporting period due to an external situation or occurrence beyond control, as well as other criteria.

The subjective nature of this process makes the research and presentation of the circumstances behind the reduction in discharges the most vital part of an application which could exceed the capabilities of your in-house team.

Our professionals understand the types of information MACs seek and can help clearly identify and strategically communicate these circumstances in a substantiative way—incorporating sound reasoning and irrefutable evidence in formats that appeal to MACs and can support easy, quick decision-making.

Providing consistent support, our professionals can help streamline your application development process, so submissions are ready prior to the required 180-day cost reporting period deadline.

Should your hospital be subject to a potential audit after submission, we can also address requests and concerns from your MAC on your behalf.

How the Process Works

Our professionals offer end-to-end services to help your hospital navigate the VDA application process:

• Discovery. With a two-year lookback, we’ll look for detailed information around discharges. We’ll try to determine what caused the decline in discharges and note any patterns—if they happened around a certain time period, in a certain department or anything else of note.
• Documentation. We’ll gather information related to cost reports, account structures, and other related data and statistics to prepare a report.
• Application. We’ll prepare a summarization of what occurred to cause the decline in discharges, as well as provide an analysis and documentation of proof to strengthen your application.

Expansive Provider Reimbursement Experience

Hospital CFOs and reimbursement departments are overwhelmed managing their day-to-day tasks, and consistently tracking the components needed for a VDA payment can get lost in the shuffle. With extensive knowledge around cost reports and evolving Medicare regulations, our professionals—with experience in VDA, wage index, and other related fields—can help guide your hospital through the VDA payment application process.

Our one-firm approach allows your organization to tap into the full resources of our firm, integrating guidance and solutions related to other integral support areas including finance, tax, audit concerns, and more.

We don’t simply provide templates or toolkits; we proactively determine appropriate solutions that help build foundations for long-term success—so you’re prepared to embrace and stay ahead of change in the reimbursement field.