CMS Publishes Approach to Limit Disruption to Physician Payments

April 10, 2015

The temporary patch to the federal “Sustainable Growth Rate” formula expired March 31, creating a 21 percent reduction to Medicare physician payments. A bill passed by the U.S. House of Representatives, which would prevent the cuts, may be considered by the Senate when it returns April 13. If passed, it could be applied retroactively to April 1. 
The Centers for Medicare and Medicaid Services (CMS) is taking steps to limit the impact on Medicare providers and beneficiaries by holding claims for a short period of time beginning on April 1. Holding claims for a short period of time allows CMS to implement any subsequent Congressional action while minimizing claims reprocessing and disruption of physician cash flow in the event of legislation addressing the 21 percent payment reduction. Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. CMS will provide more information about next steps by April 11, 2015. WSHA staff are also seeking additional detail on the process from Noridian, the Medicare Administrative Contractor for our region. (Andrew Busz)
Legislators Unveil Vastly Differing Approaches to State Budget
Less than a week apart, the State House and Senate unveiled, heard, and passed in their respective chambers, very different state budget proposals. These two budgets are significantly far apart, with the House adding $1.4 billion in new revenue and the Senate relying more on program cuts, economic growth and fund transfers to balance the budget. There are also significant differences in how the budgets treat mental health funding and the hospital safety assessment program, two top budget priorities for WSHA and it members. The good news is neither budget includes a provision in the Governor’s budget to cut hospital-based clinic fees in order to save $42 million. Both budgets include significant new funding for mental health.    
WSHA testified in support of the House budget, particularly focusing on its strong investment in mental health. WSHA also testified in opposition to the Senate budget, based on concerns about its treatment of the hospital safety net assessment program. The Senate budget levies a higher assessment rate on hospitals than the House, takes more money to the state general fund, and uses the assessment program as a vehicle to fund residency slots. While WSHA supports more residency slots, the funding is taken directly from hospitals. The Senate budget breaks the partnership WSHA was seeking when it developed its proposal to extend and enhance the safety net assessment program, originally scheduled to phase down next year. 
For specifics, please read the report on the safety net program, For the House budget, read the report linked here.
The next step is for the House and Senate to resolve the differences through conference negotiations. Because the differences are so significant, it will be difficult to agree on a compromise budget by the end of the regular legislative session which expires April 26. A special session could be necessary. (Andrew Busz)

Washington Health Benefit Exchange Releases Annual Enrollment Report
The Exchange has released its second annual open enrollment report. The data, current through early March, is rich with enrollment information, including plan participation and enrollment by county. Based on the data and a recent national study, though 2015 enrollment growth in Qualified Health Plans has been on the low side, Medicaid Expansion enrollment continues to be robust. Including both Qualified Health Plan and Medicaid Expansion enrollment, nearly 700,000 residents have gained access to free or low cost coverage through Washington Healthplanfinder. Overall, the rate of uninsured Washington State residents has dropped by roughly 40 percent.
To view past data reports, please visit the Washington Health Benefit Exchange News Center. (Zosia Stanley)
WSHA Creates Infographics on Economic Impact of Hospitals, Patient Safety Successes
WSHA recently created infographics to help it and its members express the economic importance and value their services provide to their communities.
Access to a range of high-quality health care services is an important part of any local economy. To help express the impact hospitals have on the economy of the state overall, we have developed this infographic that outlines the number of patients we care for, the number of people we employee, and the amount of charity care that we provide.

Click here to view, download and print a PDF of “Hospitals Support Communities”. (Mary Kay Clunies-Ross)
Patient Safety Means Fewer Harms and Millions Saved

Take a look at this colorful infographic to see how the Patient Safety Program is helping patients get better faster, and is reducing cost. With fewer harms and millions saved, the Patient Safety Program is ensuring that the triple aims of better health, better care and lower costs are achieved in health care.
Click here to view, download and print a PDF of “Patients are Getting Better, Faster.” (Mary Kay Clunies-Ross)



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