Archive for hospitals


Groups Seek Funding for Children’s Hospital Graduate Medical Education

Provide $400 million in funding for children’s hospital graduate medical education programs in the FY 2020 budget, 28 groups have asked congressional leaders in a recent letter.

The letter, sent to the chairs and ranking members of the Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services, and Related Agencies and the same subcommittee of the House Appropriations Committee, notes that

Sustaining pediatric training programs at children’s hospitals to meet the need of children, now and in the future, requires bolstering our national commitment.  Support for training pediatric providers through CHGME (children’s hospitals graduate medical education) lags behind the per-trainee levels provided through other federal programs.  We cannot risk falling behind in advancing children’s health.  Ongoing workforce shortages need to addressed, most acutely among pediatric specialties such as developmental pediatrics, child and adolescent psychiatry, and pediatric genetics and genomics, and CHGME is mission to meeting this need.

Read the letter and see a list of the organizations that sent it here.…

MACPAC Recommends Changes in Medicaid Shortfall Definition

Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress.  That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments.

Last week the Medicaid and CHIP Payment and Access Commission voted overwhelmingly to change how hospitals calculate their Medicaid shortfall:  the difference between what they spend caring for their Medicaid patients and what Medicaid pays them for that care.  Under MACPAC’s proposal, hospitals would need to deduct from their shortfall total all third-party payments they receive for the care they provide to their Medicaid patients.

If this proposal were to be adopted, it has the potential of changing Medicaid DSH allocations among the states and change the distribution of Medicaid DSH funds within individual states, although the Congressional Budget Office estimates that it would have little impact on either measure.

Complicating the MACPAC recommendation is last year’s federal court ruling that third-party payments could not be deducted from hospitals’ Medicaid shortfall totals because the Centers for Medicare & Medicaid Services lacks the authority to implement such a policy.  Making such a change therefore would require action by Congress.

Learn more about the MACPAC recommendation and its potential implications for hospitals …

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s April agenda were:

  • Expanding the use of value-based payment in Medicare
  • Medicare Shared Savings Program performance
  • Redesigning the Medicare Advantage quality bonus program
  • Increasing the accuracy and completeness of Medicare Advantage encounter data
  • Evaluating patient functional assessment data reported by post-acute-care providers
  • Options for slowing the growth of Medicare fee-for-service spending for emergency department services
  • Options to increase the affordability of specialty drugs and biologics in Medicare Part D
  • Improving payment for low-volume and isolated outpatient dialysis facilities

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.


Prospects Mixed for Non-Profit Hospitals in 2019

There’s good news and bad news for non-profit hospitals in 2019, according to Fitch Ratings, the bond-rating company.

The good news:

  • For many, major IT investments have been completed.
  • Many have adjusted to the reality of falling inpatient volume.
  • Many that saw reduced margins as a result of launching, purchasing, or participating in provider-sponsored plans to compete in health exchanges have scaled back those efforts.

The bad:  profits and margins may continue to decline – but those declines will not be as steep as they have been in recent years.  Reimbursement may be weaker, too.

Learn more from the Fierce Healthcare article “Why Fitch outlook on nonprofit hospitals says there are ‘ample reasons for optimism.’”


ACA Repeal Would Drive Up Uninsured, Uncompensated Care

At the same time that the Trump administration announced that it has asked a federal court to repeal the entire Affordable Care Act, the Urban Institute has published a report detailing the potential impact of the health care reform law’s repeal.

According to the Urban Institute report, repealing the entire Affordable Care Act would add almost 20 million Americans to the ranks of the uninsured.  Medicaid and CHIP enrollment would fall by 15.4 million people and millions of others would lose the tax credits they used to purchase insurance.  Some would purchase insurance with limited benefits and individual plan premiums would rise while others would go uninsured.

In addition, repeal of the Affordable Care Act would lead to an 82 percent increase in hospital uncompensated care, to more than $50 billion.  About half of the states would see the amount of uncompensated care provided by their hospitals double, the Urban Institute estimates.

Learn more from the Healthcare Dive article “Killing ACA would lead to huge spikes in uncompensated care” and from the Urban Institute report State-by-State Estimates of the Coverage and Funding Consequences of Full Repeal of the ACA.