Plans Underway to Avert Medicaid DSH Cuts

Opponents of large hospital payment cuts scheduled to begin next year under a provision of the Affordable Care Act (ACA) are lining up their plans to stop it once again.

Billions of dollars in cuts to the Medicaid Disproportionate Share Hospital (DSH) program, which is designed to offset costs of care for low-income uninsured and publicly insured patients, were required by the ACA to help pay for the coverage expansions in the healthcare reform law.

“We saw that Medicaid expansion does cut hospitals’ uncompensated care costs, so in the overall levels that becomes a reasonable way to try to fund some of the coverage expansion,” Benjamin Sommers, a professor at the Harvard School of Public Health and a Medicaid payment researcher, said about the DSH cuts at a Sept. 23 congressional briefing.

For instance, a recent analysis estimated that hospital uncompensated care costs in states that expanded Medicaid decreased from 4.1 to 3.1 percentage points of operating costs. Uncompensated care costs would have decreased from 5.7 to 4.0 percentage points of operating costs for hospitals in non-expansion states had those states expanded the program.

“The challenge is that every hospital does not see the average effect,” Sommers said.

Potentially major financial impacts on some safety […]

By |September 30th, 2016|Medicare/Medicaid|Comments Off on Plans Underway to Avert Medicaid DSH Cuts

Hiring and Training for Patient-Friendly Interactions

The importance of patient financial services staff in a hospital or health system’s success may not be recognized throughout organizations, but Chris Kiser of Carolinas HealthCare System (CHS) is on a mission to change that.
“We still, within the industry, have people that think of patient access as basically just the clerical person that enters a little bit of data—they don’t put a lot of value on the job,” says Kiser, vice president for patient financial services at CHS, which owns or manages 39 hospitals in North and South Carolina.
Kiser is spending “a lot of my time educating a lot of people” about the importance of patient financial services staff.  In an era of healthcare consumerism, those staff members often are the first and last health system employees to interact with patients. Their performance can influence whether patients choose to pay their out-of-pocket expenses on time, return for subsequent services, or speak well of an organization to friends and family.
Meanwhile, patient financial services staff data-collection and data-entry responsibilities have become more complicated as more health insurance plans have become available.
“I encourage the administrators of our various hospitals to go watch our team so they can see how complicated what they […]

By |September 30th, 2016|Uncategorized|Comments Off on Hiring and Training for Patient-Friendly Interactions

A New Reality Check for the Healthcare Industry

The complexity of billing continues to increase with regulatory changes, new payment models, the Affordable Care Act, higher deductibles, cost sharing, consumerism, and significant decreases in reimbursement to providers.

Healthcare operates in a world of continual changes, and the challenge is that hospitals have to respond to those changes. That reality, coupled with the impending 2016 presidential election, means there will only be more challenges to come.

This story and more in the October issue of ACA Pulse.

By |September 29th, 2016|Health Reform, Industry News|Comments Off on A New Reality Check for the Healthcare Industry


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