Rate Setting

About Rate Setting

Health care must be more affordable — but rate setting is not the answer. Capping the rates that health insurance companies pay to hospitals not only reduces resources for services on which communities rely, but also fails to address the true cost drivers of health care and in no way guarantees that the windfalls insurers would realize will be passed on to consumers in the form of lower monthly insurance premiums.

Hospitals are committed to providing a broad range of high-quality health services — 24/7 emergency care, leading-edge surgeries, advanced diagnostics, optimal labor and delivery care throughout the state. Cutting the resources that support these services, without consideration of the impact on patient care, could lead to adverse short- and long-term consequences for patients and communities. And in many areas — such as behavioral health care, which is facing a structural workforce shortage — more investment is needed to ensure Californians’ needs are met.

Overview of Changes to the Medicare BPCI-A Payment Model

CMS recently announced the extension of the Bundled Payments for Care Improvement Advanced (BPCI-A) model. Join us for this informative webinar as experts provide an overview of the model, including updates for 2024 participation, application considerations, and program details. Organizations that have never applied for BPCI-A, as well as current BPCI-A participants, will benefit from […]

CHA Alert Urges Congress, CMS to Fix Inadequate Inpatient Payment Proposal

CHA recently issued an alert urging members to call or email their U.S. representatives and ask them to sign a letter being circulated by Reps. Brad Schneider (D-IL) and Carol Miller (R-WV).   The letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, urges CMS to ensure that next year’s Medicare payments to […]

CHA to Host Member Forum on Draft Medi-Cal Managed Care RFP

On June 17 from 3 to 4 p.m. (PT), CHA will host a member forum to present an overview of the draft request for proposal for the Medi-Cal managed care plan (MCP) contract and the upcoming Medi-Cal MCP procurement that was released by the Department of Health Care Services on June 1.  Ryan Witz, CHA vice president of health care […]