Archive for hospitals

 

Financial Outlook Weak as Non-Profit Hospitals Face Challenging 2021

Non-profit hospitals face numerous challenges to their financial health in 2021, according to a recent analysis by Moody’s, the bond-rating company.

Among those challenges are weak cash flow caused by reduced non-urgent procedures; weak demand; a shift of patients to lower-cost, lower-revenue outpatient settings; changes in payer mix as Medicaid enrollment continues to rise and more patients lose their health insurance; and COVID-19-related expenses that continue to drive up costs.

Learn more about Moody’s outlook for non-profit hospitals in 2021 in the Fierce Healthcare article “Moody’s:  Not-for-profit hospitals face major cash constraints, negative outlook for 2021.”…

GAO Calls for More Work Scrutinizing Hospitals’ Tax-Exempt Status

The question of whether non-profit hospitals are doing enough to justify their tax-exempt status is the focus of a new Government Accountability Office study on the manner in which the Internal Revenue Service evaluates hospitals’ tax exemption.

According to the study, the IRS struggles with one of the three primary criteria for non-profit hospitals’ tax-exempt status outlined in the Affordable Care Act (PPACA):  whether the community benefit such hospitals provide justifies their tax exemption.

The GAO review observed that

While PPACA established requirements to better ensure hospitals are serving their communities, the law is unclear about what community benefit activities hospitals should be engaged in to justify their tax exemption.  The Internal Revenue Service (IRS) identified factors that can demonstrate community benefits, but they are not requirements.  IRS does not have authority to specify activities hospitals must undertake and makes determinations based on facts and circumstances.  This lack of clarity makes IRS’s oversight challenging. Congress could help by adding specificity to the Internal Revenue Code (IRC).

The GAO report also notes that

…according to IRS officials, hospitals with little to no community benefit expenses would indicate potential noncompliance.  However, IRS was unable to provide evidence that it conducts reviews related

CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week.

Among the changes announced by the Centers for Medicare & Medicaid Services:

  • A 2.9 percent increase in fee-for-service inpatient rates.
  • A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans.
  • Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments.
  • A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments.
  • Minor adjustments in the Medicare area wage index system.
  • Refinements in the Medicare graduate medical education program.
  • A new DRG for CAR T-cell payments and a new pathway to Medicare add-on payments for FDA-approved antimicrobial products.

Learn more from CMS’s fact sheet or see the final regulation itself.…

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The February 2020 MACPAC meeting opened with a continuation of MACPAC’s examination of Medicaid’s role in maternal health, when Medicaid officials from Michigan, New Jersey, and North Carolina joined the Commission to discuss how their states are addressing maternal morbidity and mortality.* The Commission plans to include a chapter on maternal health in its June 2020 report to Congress. Commissioners later turned their attention to policy options for improving enrollment in the Medicare Savings Program.

The Commission later took a deep dive into value-based payment in Medicaid managed care. This three-part session began with findings from a series of interviews with state officials, managed care organizations, and other stakeholders aimed at understanding how states use managed care to promote payment reform, conducted by MACPAC contractor Bailit Health. Then, representatives from three of these organizations shared their reactions to the findings and talked about how value-based payment models are working in practice.* The session concluded with Commissioners’ perspectives on the study’s findings and the panelists’ reactions to them, and possible next steps.

The

Comfort, Not Quality, Woos Patients

People are more likely to recommend a hospital based on the comfort they felt when hospitalized rather than on the quality of the care they received, a new study has found.

Good food, rooms with a view, friendly nurses, peace and quiet, more television channels, and other amenities impress patients more than higher survival rates and lower hospital-acquired conditions rates.

These are among the findings from an analysis of patient satisfaction data from 3000 hospitals between 2007 and 2010.

Learn more about how inpatients view their hospital experiences and how those experiences shape how they rate hospitals in Oxford Academic’s Social Forces article “Patients as Consumers in the Market for Medicine: The Halo Effect of Hospitality” and find a summary of that analysis in the HealthLeaders Media article “Hospitality Trumps Clinical Outcomes When It Comes To Patient Satisfaction.”…