Finance & Reimbursement

About Finance & Reimbursement

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.  

CMS Issues FFY 2020 IPPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) this week released its federal fiscal year (FFY) 2020 inpatient prospective payment system (IPPS) proposed rule. In addition to annual payment updates, including changes to Medicare disproportionate share hospital (DSH) payments, CMS proposes significant changes to the hospital area wage index. CHA believes this proposal inappropriately and unnecessarily punishes states like California with a high cost of living and is analyzing the impact of the proposal to determine an appropriate political and policy response.

CMS Approves Hospital Fee Program Managed Care Rates

This week, the Department of Health Care Services shared four approval letters, dated April 10, from the Centers for Medicare & Medicaid Services (CMS). While these letters mention approval is for state fiscal year 2016-17, the rates approved only include the Hospital Fee Program for June 1 to Dec. 31, 2016.

CHA DataSuite Releases Fourth Quarter 2018 Impact Analyses

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). 

2017-19 Hospital Fee Invoices Due April 3

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.