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
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.
Earlier this week, CHA attended a Senate Health Committee informational hearing that examined strategies across all purchasers and programs that have the objective of improving the care delivered to people with chronic conditions.
Today, the Department of Health Care Services (DHCS) will release the final Phase 1 (June 1-Dec. 31, 2017) encounter volume charts for the Hospital Fee Program to all health plans and hospitals. The data will be available via the Secure File Transfer Protocol site.
A CHA members-only webinar on Feb. 21 from 9:30-11 a.m. will provide information on recent changes to how Medi-Cal managed care plans can make supplemental payments through the Hospital Fee Program.
Last week, the Department of Health Care Services (DHCS) sent hospitals invoices covering the first 18 months of managed care cycles for the 2017-19 Hospital Fee Program. Fees are due to DHCS March 13.
CHA has provided member hospitals and health systems with revised reports to provide them with a comparative review of the wage and occupational mix data that will be used to develop the federal fiscal year (FFY) 2020 Medicare hospital wage index.
The Centers for Medicare & Medicaid Services (CMS) has granted exceptions under certain Medicare quality reporting, value-based purchasing and payment programs to providers located in Butte, Los Angeles and Ventura counties, which have all been designated by the Federal Emergency Management Agency as major disaster areas (DR-4407) due to the impact of the California wildfires.
On Jan. 30 from 3-4 p.m. (PT), The Department of Health Care Services (DHCS) will host a webinar to provide guidance for health plans and hospitals on the changes to network provider requirements.