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.
2025 Hospital Finance & Reimbursement Conference Agenda Now Finalized
What’s happening: On Nov. 3-4, California hospital finance experts will gather at CHA’s members-only Hospital Finance & Reimbursement Conference to examine the fiscal impact of state and federal regulations and policies on hospitals.
Public Comments Due Oct. 17 for DHCS’ 2026 Distinct Part Nursing Facility, Subacute Draft Rates
What’s happening: The Department of Health Care Services (DHCS) recently posted the calendar year (CY) 2026 draft rates for Distinct Part Nursing Facilities, Level B and Distinct Part Subacute on its website.
H.R.1 Implications and Hospital Quality Assurance Fee Overview
CMS 2026 OPPS Proposed Rule
Preparing for Transforming Episode Accountability Model (TEAM) Participation
Federal Funding Will Bolster Medi-Cal Reimbursement for Inpatient Psychiatric Care
What’s happening: On Dec. 16, California was approved for the large BH-CONNECT behavioral health demonstration project, which is estimated to bring $5 billion of new federal Medicaid dollars for California over the next five years.
Managed Care Organization Tax
On Nov. 5, California voters overwhelmingly approved Proposition (Prop) 35, making an existing tax on managed care organizations (MCO) permanent under state law — and directing most of the revenues toward expanding access to care for Medi-Cal patients through improved provider reimbursement. Now, work by the state, hospitals, and others to determine how these funds...
TEAM Bundled Payment Final Rule Webinar – Participant Information
Over 100 California hospitals were selected to participate in the finalized Transforming Episode Accountability Model (TEAM). Additionally, current participants in other Medicare bundled payment models can opt into TEAM which begins in January of 2026.
CHA Encourages Members to Participate in the Vitality Index Payer Scorecard
What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.
Dual Eligible Medi-Cal Managed Care Enrollment — Participant Information
CalAIM is standardizing Medi-Cal coverage for people enrolled in both Medi-Cal and Medicare with changes for many Californians starting next year. On January 1, 2023, those enrolled in Medicare and Medi-Cal, who currently receive their Medi-Cal benefits through traditional fee-for-service, will have their Medi-Cal benefits transitioned to Medi-Cal managed care statewide, which could mean changes...