About Finance & Reimbursement
Vulnerable Californians who rely on the care provided by California hospitals are at risk. Driven by skyrocketing costs for labor, pharmaceuticals, regulatory mandates, and more, 53% of all hospitals statewide lose money every day to deliver patient care.
That isn’t sustainable. And California is already seeing the frightening result: rural health care services being cut to the bone, severe behavioral health care needs not being met, and more.
Recording of Hospital Fee Program Executive Briefing Now Available
What’s happening: A recording of CHA’s March 18 executive briefing on the Hospital Fee Program is now available for members who may have missed it.
Medicaid State-Directed Payments Help Ensure Patient Access to Care
About State-Directed Payments (SDPs) SDPs are additional payments made to health care providers to support Medicaid quality and access goals. The Centers for Medicare & Medicaid Services (CMS) reviews and approves SDPs for each 12-month rating period. Payments to providers are made via managed care organizations (MCOs) and are based on utilization of Medicaid services....
Medicaid Provider Taxes Protect Californians’ Access to Care
Medicaid provider taxes are a cornerstone of the Medicaid financing structure. Without federal revenue generated from these taxes, reimbursement for care provided to patients covered by Medicaid would be woefully insufficient and health care access would be at grave risk. For many hospitals, losing this revenue would mean closure of service lines; for others, it...
CHA Document Details Considerations for Freestanding ED Model
What’s happening: Recognizing that some hospital leaders have expressed interest in the concept of freestanding emergency departments (EDs) — which are not currently permitted in California — CHA has developed a document that outlines the current regulatory landscape and key considerations for this type of service model.
State Files Revised Hospital Fee Program Application
What’s happening: Last week, the California Department of Health Care Services (DHCS) submitted its revised Hospital Fee Program tax model for calendar year 2025 (Program 9) to the Centers for Medicare & Medicaid Services (CMS).
Future of Medi-Cal Commission Advisory Group Discusses Draft Priorities
What’s happening: The Advisory Group for the Future of Medi-Cal Commission held its second meeting on March 3. The group met to review and provide feedback on draft priorities that will help shape the commission’s recommendations for the long-term direction of California’s Medicaid program.
CHA Alert: Action Needed on Distressed Hospital Loan Program, Hospital Mandates Bills
What’s happening: Earlier this week, CHA issued a dual alert asking members to sign on to coalition letters for its two sponsor bills: Assembly Bill (AB) 2353 (Pacheco, D-Downey), which would require an independent cost evaluation of mandates on hospitals, and AB 1923 (Soria, D-Merced), which would revive the Distressed Hospital Loan Program. For AB 2353, members should also submit a support letter highlighting previously imposed mandates that have caused the hospital to...
Future of Medi-Cal Commission Advisory Group Discusses Draft Priorities
What’s happening: The Advisory Group for the Future of Medi-Cal Commission held its second meeting on March 3. The group met to review and provide feedback on draft priorities that will help shape the commission’s recommendations for the long-term direction of California’s Medicaid program.
Affordability, Drug Pricing in Focus at Key AHA Meeting
Discussions at this week’s American Hospital Association Regional Policy Board 9 meeting will delve into several timely and weighty issues for hospitals in California and nationwide.
State Consulting Contract Targets Medi-Cal Oversight, Program Integrity, and Hospital Payment Reform
What’s happening: The California Department of Finance has hired Boston Consulting Group — under a contract worth up to $20 million — to identify cost savings and operational improvements across several state programs, including oversight of Medi-Cal managed care plans, Medi-Cal fraud detection, and hospital payment policies.