Hospitals
Hospitals today are an industry under siege. They grapple with the growing pressures on their Emergency Departments (EDs) from the increasing number of uninsured patients who find their only source of care in the ED. And as both the states and the federal government increase their reliance on managed care, there is pressure to both reduce days that care is provided in a hospital and the length of the stays that are deemed necessary. These factors put enormous pressure on hospitals to determine appropriate staffing patterns and forecast budgets.
At the same time, hospitals are experiencing a reduction in their payments from all sectors as the federal and state governments reduce Medicare and Medicaid payments and the private sector trades low rates for high volume.
The American Recovery and Reinvestment Act does provide some much-needed relief in the form of increases in the FY ‘09 Disproportionate Share Hospital (DSH) payments. The bill increases states’ FY 09 allotment by 2.5 % and increases their allotment for 2010 by 2.5% above the new FY ‘09 allotment.
This is welcomed if only temporary relief, because after 2010, states’ annual DSH allotments will return to 100 % of the annual DSH allotments as determined by current law.
And, although the bill extends the moratorium on Medicaid regulations, which impact hospitals, it is set to expire on June 30, 2009.
In other words, hospitals must continue to meet financial requirements, struggle with growing uninsured patient populations, and deal with the issues surrounding national health care reform.
It's a new day. And hospitals must re-invent themselves to deal with these new realities.
But how?
That's where we come in.
AS&A has a firm grip and a watchful eye on the federal moratoria and evolving policies related to reimbursement. We can walk hospitals through every facet of the American Recovery and Reinvestment Act . We stand ready to help them take advantage of the $19 billion investment the bill makes in the health information technology infrastructure, such as electronic health records.
With our national reputation and decades of experience in all aspects of the Medicaid field, we assist individual hospitals and consortia in responding to these changing policies and help them maximize their funding opportunities so they can deal with these new realities.
Take a look at our clients’ stories….what we did with them, we can do with you.
Story 1
THE OVERVIEW
A statewide hospital association came to AS&A with its business challenge: The hospitals, through their association, have struggled with historically low payment rates and had devised a federally sanctioned approach to generating and receiving supplemental payments. However, over the past 5 years, the federal government has continued to "evolve" its policy, making a stable reimbursement system almost impossible to maintain.
THE ACTION
*We worked with the Association to develop a rationale to support the continuation of its initial supplemental payment program.
*When CMS required that the state eliminate the supplemental program, we worked with the Association and its member hospitals to create a new approach built on the certification of public expenditures by the state's public hospital community.
*We continue to be involved with the Association as it works in concert with other state associations to maintain the certification approach as a valid means of generating federal match for hospital payments.
THE OUTCOME
The Association continues to call on AS&A when work is on-going relative to addressing the implications of evolving federal policy for hospital payments.
Story 2
THE OVERVIEW
A statewide hospital association turned to AS&A for a project that involved seeking broad consensus among the member hospitals for a methodology through which the state/federal Disproportionate Share Hospital funds could be distributed.
THE ACTION
*We began by working directly with the Board of the Association to increase their understanding of the underpinnings of the statute governing the DSH program to assure that consensus would be based on this knowledge.
*We visited each Board member's hospital, discussing issues with CEOs and CFOs.
*We assisted the Association staff in developing a proposal that all hospitals were able to agree with and that met both state and federal guidelines.
THE OUTCOME
A consensus was achieved and a methodology that met federal approval was validated by both the state and federal governments. The Association continues to call on AS&A on an "on-going" basis for consulting on policy issues.
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