The Volume Decrease Adjustment (VDA) is an important benefit to assist Medicare Dependent Hospitals (MDH) and Sole Community Hospitals (SCH) when they experience a decline in inpatient volume of greater than 5%. In order to receive the money, a written request must be submitted to the Medicare Administrative Contractor (MAC). There are several pieces of information that must be submitted in order to collect the VDA. They are:
- General Information – Your facility’s name, address and provider number.
- Discharge data – You must document that inpatient discharges declined by more than 5%.
- Circumstances – This is the most important piece of information. You must provide an explanation for what caused the decline, demonstrate that it was beyond your control, and show what steps were taken to prevent or reduce the decline in inpatient volume.
- Show the impact of the decline on per discharge costs.
- A narrative description of efforts to reduce costs.
- The calculation of the payment adjustment, including a review of the trial balance and a classification of expenses as fixed, semi-fixed, or variable.
Each piece of information will be reviewed and verified by the MAC prior to their issuing a determination and hopefully payment. For that reason, it is important that the request be thorough and verifiable. Most requests prepared by The Rybar Group involve 20 – 30 pages of narrative, and over 100 pages of supporting exhibits.
Missing information or information submitted without supporting documentation will result in data requests from the MAC which will delay the process. The Rybar Group has over 30 years of experience requesting VDAs which helps us prepare a complete request, enabling a smooth review process. Please contact Steve Sprague, ssprague@therybargroup.com or 810-853-6169, today to discuss your situation.
