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.
CHA DataSuite Analysis of CY 2025 Medicare OPPS Final Rule Shows Fee-for-Service Payment Changes from CY 2024
What’s happening: CHA DataSuite has issued a hospital-specific analysis of calendar year (CY) 2025 Medicare outpatient prospective payment system (OPPS) final rule.
What else to know: The analysis is intended to show providers how Medicare outpatient fee-for-service payments will change from CY 2024 to CY 2025 based on the policies set forth in the final rule.
CHA Issues Summaries of CY 2025 OPPS, Physician Fee Schedule Final Rules
What’s happening: Summaries of the calendar year (CY) 2025 outpatient prospective payment system (OPPS) and physician fee schedule final rules are available for CHA members.
What else to know: The rules are effective Jan. 1, 2025.
182 Members of Congress Sign Letter to Prevent Medicaid DSH Cuts
What’s happening: A bipartisan letter asking House leadership to prevent upcoming Medicaid disproportionate share hospital (DSH) payment cuts gathered 182 signatures — including 36 from the California delegation. CHA thanks hospital leaders for their outreach on this critical issue.
What else to know: Reductions in Medicaid DSH payments to states are scheduled to take effect on Jan. 1, 2025. If these cuts go into effect, California’s hospitals would lose $1.2 billion in 2025.
CHA DataSuite CY 2025 HH Final Rule Impact Analysis Shows How Medicare FFS Payments Will Change
What’s happening: CHA DataSuite has issued a hospital-specific analysis of the calendar year (CY) 2025 Medicare home health (HH) prospective payment system final rule analysis.
What else to know: The analysis is intended to show HH providers how Medicare fee-for-service (FFS) payments will change from CY 2024 to CY 2025 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members.
As 2024 Winds Down, Federal Advocacy Heats Up
As 2024 begins to come to a close, CHA’s advocacy attention will be focused on advancing priorities in Washington, D.C. We’ll be pushing to ensure federal approval for two critical state issues while also focusing on some key federal issues likely in play in the lame duck session.
Urge Congress to Support Patient Care in Year-End Legislation
What’s happening: CHA issued an alert asking members to urge their congressional representatives to support hospital priority issues in year-end legislation.
What else to know: Outreach is needed by Dec. 20 when Congress will wrap up the session.
CHA Supports Eliminating Low Wage Index Hospital Policy for FFY 2025
What’s happening: CHA submitted comments in support of an interim final rule that eliminates the low wage index policy and associated budget neutrality adjustment for federal fiscal year (FFY) 2025.
What else to know: The rule was issued by the Centers for Medicare & Medicaid Services (CMS) in response to the U.S. Court of Appeals for the District of Columbia Circuit (D.C. Circuit) decision in Bridgeport Hospital, et al., v. Becerra.
HQI Virtual Forum to Discuss Workplace Violence in Rural, Critical Access Hospitals
What’s happening: Individuals leading and supporting hospital efforts to eliminate workplace violence are invited to the next Hospital Quality Institute (HQI) virtual forum on Dec. 12 at noon (PT).
What else to know: The forum will discuss workplace violence concerns and interventions specific to critical access and rural hospitals. Registration is open, and participation is free for all CHA and HQI member hospitals.
Hospital Fee Program 9 (2024)
With each Hospital Fee Program renewal, DHCS retrieves the requisite hospital data and updates the fee and payment model as directed under the authorizing legislation found under state law (specifically, the Medi-Cal Hospital Reimbursement Improvement Act of 2013 codified at Welfare and Institutions Code sections 14169.50 through 14169.76).
Register for Upcoming DataGen Webinar on CY 2025 OPPS Final Rule
What’s happening: On Dec. 5 at noon (PT), a DataGen webinar will share an overview of and the calendar year 2025 outpatient prospective payment system (OPPS) final rule and analysis. What else to know: CHA encourages members to register for this webinar.