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.
Managed Care Organization Tax
On Nov. 5, California voters overwhelmingly approved Proposition (Prop) 35, making an existing tax on managed care organizations (MCO) permanent under state law — and directing most of the revenues toward expanding access to care for Medi-Cal patients through improved provider reimbursement. Now, work by the state, hospitals, and others to determine how these funds […]
Hospital Fee Program Status
The Hospital Quality Assurance Fee (HQAF) Program and all of its statutory provisions were made permanent through the passage of CHA’s ballot initiative, the Medi-Cal Funding and Accountability Act (Proposition 52), in the November 2016 general election. While this provides the framework for all future hospital fee programs, future iterations must adhere to federal regulations related to health-care provider taxes. Further, the Department of Health Care Services (DHCS) must obtain all necessary federal approvals.
Prop 35 Advisory Committee Will Convene May 19
What’s happening: On May 19 from 10 a.m. to 3 p.m. (PT), the Proposition (Prop) 35 “Protect Access to Health Care Act” Stakeholder Advisory Committee will hold its second meeting at the Department of Health Care Services (DHCS) in Sacramento. This meeting is open to the public, and registration for virtual attendance is open.
Hospital Fee Program 8 Invoices Past Due
What’s happening: Payments for the Hospital Quality Assurance Fee program 8 fee-for-service were due to the Department of Health Care Services (DHCS) on May 7.
Hospital Leaders Take Message on Threats to Medicaid, Medicare to Capitol Hill
What’s happening: As part of the American Hospital Association Annual Meeting held in Washington, D.C., this week, California hospital and health system leaders participated in more than 20 meetings with the California congressional delegation.
Four New Analyses Cover Medicare Quality Programs, Medicare Spending Per Beneficiary, Inpatient Quality Measure Trends, Value-Based Purchasing
What’s happening: CHA DataSuite released four hospital-specific analyses intended to provide hospitals with a preview of impacts and trends related to various programs.
Upcoming Webinar to Detail IPPS Proposed Rule’s Impact
What’s happening: On May 21, CHA will host a members-only webinar to discuss the Centers for Medicare & Medicaid Services’ (CMS’) federal fiscal year (FFY) 2026 inpatient prospective payment system (IPPS) proposed rule, which includes a net 2.4% payment rate increase — far below what hospitals need to keep up with rising costs and health care needs.
CHA Recommends Prop 35 Funding Methodology to DHCS
What’s happening: On April 25, CHA submitted to the California Department of Health Care Services (DHCS) comments on how to best allocate Proposition (Prop) 35 funding in 2025 and beyond.
Next Week’s Prop 35 Webinar to Examine Delays, Share CHA’s Strategy
What’s happening: On May 8, CHA will host a members-only webinar to provide an overview of Proposition (Prop) 35 and CHA’s strategy to push for expeditious implementation, and share when dollars may realistically flow to hospitals.
FFY 2026 IPPS Proposed Rule Webinar
As required annually by law, the Centers for Medicare & Medicaid Services (CMS) has issued its federal fiscal year (FFY) 2026 inpatient prospective payment system (IPPS) proposed rule. CMS proposes to increase payment rates for most hospitals paid under the IPPS by 2.4% in FFY 2026. The net impact of the proposed rule will increase payments […]
Members-Only Summaries Detail Post-Acute Care, Psychiatric Facility Payment Provisions for FFY 2026
What’s happening: Summaries of the inpatient rehabilitation facility (IRF) prospective payment system (PPS), skilled-nursing facility (SNF) PPS, hospice wage index, and inpatient psychiatric facility (IPF) PPS proposed rules are now available.