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In This Issue
CBO Projects Hospital Profit Margins In 2025
MHA Comments On Proposed Medicaid DSH Regulations
CMS And OCR Revise Civil Rights Clearance Procedure
MHA Updates Quality Reporting Guides
state and federal health policy developments
Staff Contact: Andrew Wheeler
The Congressional Budget Office released an analysis that projects hospital profit margins in 2025. The report focuses on implications of the Affordable Care Act, the decrease in the uninsured due to improved insurance coverage, revenue increases needed to sustain positive operating margins, productivity growth and use productivity to limit increases in cost. According to the report, approximately 27 percent of hospitals were unprofitable in 2011. The CBO projects that by 2025, 41 percent of hospitals will be unprofitable, assuming their productivity growth equals that of the economy as a whole, and that hospitals use those gains in productivity to limit the growth in expenses. If hospitals do not improve productivity, 60 percent are likely to be unprofitable by 2025. The CBO further states that for hospitals to remain at 2011 profit margins, an additional 0.2 percent to 0.5 percent revenue growth will be needed.
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the latest actions of agencies monitoring health care
Staff Contacts: Daniel Landon or Kim Duggan
MHA has submitted a comment letter responding to the Centers for Medicare & Medicaid Services’ proposed rule that purports to codify the CMS policy interpretation regarding how the Medicaid DSH payment program determines costs for Medicaid eligible patients that also have a third-party source of coverage. The deadline for submitting comments is 4 p.m. Wednesday, Sept. 14.
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Staff Contacts: Sarah Willson or Jim Mikes
The Centers for Medicare & Medicaid Services and the Office of Civil Rights have revised the procedure for civil right clearance recently issuing a survey and certification letter. The new procedure impacts all providers seeking initial certification or those who are forwarding notification of a change of ownership. The new process requires all state agencies to revise their application packets and providers to electronically submit the assurance of compliance attestation (HHS Form 690) to OCR.
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Quality and Population Health
Staff Contact: Dana Dahl
MHA has updated the acute care and specialty services quality reporting guides to include current information from recent publications, including the fiscal year 2017 inpatient PPS final rule. The guides support hospitals with reporting quality measures through various reporting programs. Download the updated guides to access direct sources of information and to stay up-to-date on measure specifics.
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From 2011 to 2015, insurers’ payments to hospitals, laboratories, treatment centers and other medical providers for opioid-treated patients grew from $32 million to $446 million — a 1,375 percent increase.
Source: Kaiser Health News