About Finance & Reimbursement
California’s hospitals are under duress, facing crippling inflation and systemic underfunding by government payers — Medi-Cal and Medicare. Every day, over half of California’s hospitals lose money caring for patients. The 2023-24 state budget reauthorizes California’s managed care organization tax, dedicating much of the revenue to support for Medi-Cal enrollees. But without meaningful change to Medicare and Medi-Cal, the most vulnerable Californians will continue to be left behind. Health insurance companies must also do their part to protect essential services, including timely reimbursement and processing of claims. reimbursement and processing of claims.
CMS Announces New Payment Model Targeting Behavioral Health
What’s happening: The Centers for Medicare & Medicaid Services announced a new Innovation in Behavioral Health (IBH) Model on Jan. 18.
What else to know: The Notice of Funding Opportunity will open in spring 2024, and up to eight states will be selected to participate.
CHA DataSuite Releases Value-Based Purchasing Program Analysis
What’s happening: CHA DataSuite has issued a hospital-specific analysis of the third quarter federal fiscal year (FFY) 2024 value-based purchasing program.
What else to know: The analysis is intended to provide a preview to hospitals of the program’s potential impact for FFY 2025, based on the most recent publicly available data and program rules established by the Centers for Medicare & Medicaid Services.
CHA Releases Advocacy Materials for 2024
What’s happening: New and updated advocacy materials are available for your use.
What else to know: Each packet contains an infographic, key messages, and an issue brief.
2024 Hospital Finance and Reimbursement Seminar
Join CHA and experts from respected law firms for insights on how new regulations, a new state agency, and imminent changes will impact Medicare, Medi-Cal, and hospital reimbursement in 2024 and beyond.
Budget Proposal Sustains Health Programs Even as Deficit Demands Vigilance
Yesterday, Gov. Gavin Newsom released his 2024 budget proposal, one that includes a myriad of fixes to patch a deficit that the Department of Finance projects to be nearly $38 billion (previous deficit estimates from the Legislative Analyst’s Office had pegged the shortfall at $68 billion).
Governor’s 2024-25 Budget Proposal Largely Maintains Health Care Commitments
What’s happening: On Jan. 10, the governor released his $209 billion state general fund budget for 2024-25. The spending plan includes a nearly $38 billion (18%) deficit before accounting for solutions.
What else to know: The governor proposes to close the deficit without major cuts to health care programs. The budget still needs to make its way through the Legislature, and the May revision will deliver new and more up-to-date revenue tallies.
CHA Summary: Final Federal Independent Dispute Resolution Fees
What’s happening: CHA has issued a final rule summary of the finalized federal independent dispute resolution (IDR) administrative fee and entity fee ranges.
What else to know: The fees are effective Jan. 22.
CHA Comments on Proposed Changes to Medicare Advantage Plans
What’s happening: CHA submitted comments on the proposed technical changes to Medicare Advantage plans for contract year 2025.
What else to know: Comments were due to the Centers for Medicare & Medicaid Services on Jan. 5.
Infographic: California Hospitals’ Uncertain Future
Issue Brief: Systemic Reimbursement Shortfalls Must Be Fixed
Medicare and Medi-Cal underfunding have put the health care system on the precipice.