Recent WSHA Bulletin Reports Good News on Medicaid Rate Adjustments

January 28, 2016

As reported in a recent WSHA bulletin, the Washington State Health Care Authority (HCA) has agreed to increase inpatient rates for the next quarter by about 18 percent. This restores errors it made to the budget neutrality adjustment factor (BNAF) rates during the last two quarters for Prospective Payment System hospitals and Certified Public Expenditure hospitals.

This work was the result of WSHA’s efforts to identify problems in the data set being used to calculate the appropriate adjustment factor. HCA agreed to the changes after several discussions with WSHA staff, high-level analysis from our consultant, Bruce Deal at Analysis Group, Inc., and detailed claims analysis from three member hospitals. We would like to thank members of the WSHA rebasing task force, especially Kelly Wallace at Seattle Children’s, for strongly suggesting the need to vet the state’s calculations after a general discussion in August of the state’s planned methodology. Our calculations show the error correction will mean an additional $60 million to hospitals for services incurred since July 2014. (Andrew Busz)


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