Even before the COVID-19 pandemic, many California hospitals’ financial situations were challenging — nearly 40% operated in the red. Hospitals strive to contain costs while delivering essential care to their communities in the most cost-effective manner. CHA provides direction to hospitals on the diverse issues that affect their financial performance, and advocates for them to ensure that much-needed programs retain their funding. In addition, CHA offers tools such as DataSuite to help hospitals analyze government reimbursement changes, and the potential impact of regulatory and legislative actions on hospitals.
About Finance & Reimbursement
CHA DataSuite has issued hospital-specific analyses showing the estimated impact of the federal fiscal year (FFY) 2020 Medicare inpatient Hospital-Acquired Condition (HAC) Reduction Program as well as the hospital Value-Based Purchasing (VBP) Program, based on publicly available data and program rules established by the Centers for Medicare & Medicaid Services (CMS).
In September 2018, the Department of Health Care Services (DHCS) sent hospitals invoices covering the last four fee-for-service (FFS) cycles of the 2017-19 Hospital Fee Program. The third invoice, Cycle 9 FFS, covers Jan. 1 – March 31, 2019, and is due April 3. Hospitals will receive the corresponding FFS payment on April 22.
The Centers for Medicare & Medicaid Services (CMS) has postponed billing edits for outpatient providers with multiple service locations — scheduled to start in April — for three additional months.
This week, the Department of Health Care Services (DHCS) shared four approval letters, dated March 18, from the Centers for Medicare & Medicaid Services (CMS). Hospitals should share the relevant letters, linked here, with their accounting firms:
County-organized health system counties
Geographic managed care counties
Rural expansion counties
CHA DataSuite has released hospital-specific reports providing a one-page historical summary of hospital quality performance and impacts for each of the Centers for Medicare & Medicaid Services three Medicare inpatient quality programs — Value-Based Purchasing, Readmissions Reduction and Hospital-Acquired Condition Reduction — from federal fiscal years 2017-19.
The Department of Health Care Services has released the slide deck shared at a webinar it hosted yesterday, offering guidance to health plans and hospitals on changes to network provider requirements under the Hospital Fee Program.
On March 14 from 9-10:30 a.m. (PT), the Department of Health Care Services (DHCS) will host a second webinar to provide guidance to health plans and hospitals on changes to the network provider requirements under the Hospital Fee Program.
The California Department of Managed Health Care (DMHC) has promulgated a new general licensure regulation, effective July 1, that greatly expands the types of health care service plans requiring a license. CHA encourages members to consult with their counsel to determine how the new regulation will impact their organization.
On March 14, the Department of Health Care Services (DHCS) will issue the first supplemental fee-for-service (FFS) payment related to the 2017-19 Hospital Fee Program. The payment will account for the approximate 6 percent shortfall that occurred with the FFS cycle 1 payment in February of 2018.
Last week, the Centers for Medicare & Medicaid Services (CMS) updated its overall hospital quality star ratings on Hospital Compare, which were last updated in December 2017.