On June 15, Washington State Health Care Authority (HCA) posted the Medicaid inpatient and outpatient hospital payment rates effective for July 1, 2022. The changes to rates, grouper versions, and weights are the result of HCA’s rebasing of its prospective payment methodologies conducted over the last year and a half. HCA and Milliman, its consultant,... Read More >>
On June 17, WSHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed inpatient hospital payment rule for 2023. WSHA provided a draft of its comments to hospital chief financial officers, government affairs staff, and rural administrators in advance of the June 17 comment deadline and encouraged interested hospitals to... Read More >>
On June 15, the U.S. Supreme Court ruled that the Centers for Medicare and Medicaid Services did not follow the necessary procedure for cuts to hospital payment for 340B hospitals. In American Hospital Association v. Becerra the AHA sued the Department of Health and Human Services (HHS) arguing the Medicare Prescription Drug, Improvement, and Modernization... Read More >>
New Medicaid inpatient and outpatient hospital payment rates will be in effect July 1, 2022, due to the Washington State Health Care Authority’s (HCA) rebasing of its prospective payment methodologies. The changes apply to hospitals that receive Medicaid payment from the Health Care Authority or managed care organizations (MCOs) for inpatient and outpatient services paid... Read More >>
Washington hospitals should be judged based on their own performance, not by the experiences in other states. Also, when comparing hospital performance across states, data should be adjusted for case mix as well as per capita hospital use. That was some of the advice given to the state’s Health Care Cost Transparency Board during a... Read More >>
The state operating budget (ESSB 5693) passed during the last legislative session included $8 million in funding for hospitals in financial distress. The Washington State Health Care Authority (HCA) is opening the application period for the distressed hospital grants authorized by the legislature. HCA will have two grant application periods with $4 million each period.... Read More >>
On May 18 the Health Care Cost Transparency Board (HCCTB) unanimously passed a motion authorizing the Board to seek additional data to inform its work, such as available data from Medicare hospital cost reports. Prior to passing this motion, the Board heard a report about Colorado hospital financial metrics, which raised significant issues with prices... Read More >>
A recent analysis of hospital claims data by the RAND Corporation determined that commercial payment rates for Washington hospitals are among the lowest in the nation, when compared to Medicare payment for the same services. According to the analysis, the aggregate differential for Washington hospitals was the third lowest among the 49 states and District... Read More >>
The Washington State Office of the Insurance Commissioner (OIC) recently posted the slide decks for their recent webinars detailing changes to state law to align the state’s Balance Billing Protection Act (BBPA) with the federal No Surprises Act (NSA) and expand the BBPA balance billing protections to include crisis behavioral health services. OIC is in... Read More >>
The Washington Health Care Authority is seeking survey responses from primary care provider groups related to their capacity to adopt the Primary Care Transformation Model. Specifically, HCA needs to understand clinic’s/practice’s current capacities and needs as it designs a sustainable primary care model for patients, providers, payers, and purchasers. Additionally, HCA seeks to determine to... Read More >>
