WSHA Provides Hospital Impact Analyses of Outpatient Rule

November 29, 2017

In the next few days, WSHA is sending hospital-specific analyses of the final Medicare Outpatient Prospective Payment System (OPPS) rule to the chief financial officer or other designated recipient at each of our member Prospective Payment System (PPS) hospitals. The reports include the estimates of the impact of the 340B payment reduction for certain hospitals and the related budget neutrality adjustment. A few highlights of the analysis:

  • Washington State hospitals will receive an estimated $5,464,100 more in OPPS payments in 2018 than in 2017, a 0.41% increase.  Nationally, the average increase from 2017 to 2018 is estimated to be 1.51%. We believe much of the difference in the state and national numbers is due the number of Washington state hospitals participating in 340B compared to other states.  In aggregate, the projected 340B cuts to Washington hospitals are estimated to exceed the budget neutrality adjustment by about $15 million.
  • Of the 55 hospitals receiving OPPS payments in Washington, 13 are estimated to receive decreased OPPS payments in 2018 compared to 2017.
  • Most hospitals in Washington are expected to experience some increases in the annual marketbasket update and additional budget neutrality adjustment compared to 2017.  However, for many hospitals the increases in these factors will be offset by decreases in other factors, such as ACA required marketbasket reductions, wage index changes and the reductions in payment for 340B drugs. (Andrew Busz,


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