Healthcare Connection

Healthcare Connection – July 25, 2017

Report: Self-Pay Becomes Ground Zero for Hospital Margins

The Affordable Care Act (ACA) repeal process continues to develop, but the initial presumptions point to increased state control, a growing uninsured population, and lower revenue realization for hospitals. As legislation evolves and high-deductible health plans continue to garner increased market share, the self-pay payer mix will have an increased impact on hospital operating margins. Read the full Crowe RCA benchmarking quarterly report for additional analyses.

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Preserving Your Fair Share of DSH Reimbursement

On April 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year 2018 inpatient prospective payment system/long-term care hospital prospective payment system proposed rule. CMS has proposed that the uncompensated care pool (UCP) calculation for Medicare disproportionate share hospitals (DSH) will transition from currently using the days proxy to using non-Medicare uncompensated care reported on the Medicare cost report (worksheet S-10, line 30). What does this mean for you? The UCP calculation is used to distribute 75 percent of the DSH payment pool to eligible hospitals. Find out how an automated approach to extracting charity care and non-Medicare bad debt amounts can improve accuracy and save you time.

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Brian B. Sanderson
Managing Principal, Healthcare Services