The cost of health care delivery is an issue that causes confusion and frustration for patients, lawmakers, and the hospitals themselves. The Washington State Hospital Association (WSHA) is providing a free and open webinar to build some basic understanding about the major factors that affect hospitals’ financial picture, and the relationship between those finances and access to health care across our state. While the webinar was developed with health care reporters in mind, we believe it will also help hospital staff explain the costs related to the provision of health care.
The webinar will a broad variety of topics related to health care costs, including payment rates, payment structures, charity care, community benefits, Medicaid expansion, the Affordable Care Act, emerging new payment models, health care in rural areas, cost and quality transparency, and more! Presenters are Andrew Busz, WSHA Policy Director, Finance and Mary Kay Clunies-Ross, WSHA VP Communications & Public Affairs. For connection information, see our webcast page. (Andrew Busz, firstname.lastname@example.org)
CMS Offers to Settle Outstanding Recovery Audit Contractor Claim Appeals
The Centers for Medicare and Medicaid (CMS) is offering hospitals the opportunity to settle for about two-thirds of the value of claims they are appealing that were denied by Recovery Audit Contractors (RACs) due to patient status. Hospitals must decide whether to request the settlement or continue with the appeal process. Hospitals desiring to settle should submit a request to CMS by October 31. Additional information regarding the process can be found on the CMS website.
To address a huge backlog of claim of over 18 months and as many 800,000 appealed claims, CMS will pay hospitals 68 percent of the net payable sum for claims admission dates prior to October 1, 2013, that the hospitals either appealed or planned to appeal which were denied by the RACs. CMS is under pressure to reduce the backlog of appeals as it seeks to re-contract with the RAC firms by the end of the year. As an interim measure, it is extending the current RAC agreements. Since the RACs were/are paid on a contingency basis, is unclear what financial impact the settlement for past claims will have under the existing RAC contracts. The proposed settlement percentage of 68 percent is significant, as it indicates recognition by CMS that the majority of appealed claims may have been inappropriately denied by the RACs, a point hospitals and hospital associations have been making to Congress for several years. (Andrew Busz, email@example.com)
DOH Letters to Hospitals Request Changes to Charity Care Policies
The Washington State Department of Health (DOH) recently sent several hospitals letters asking for updates to their charity care policies. Earlier this year, DOH thoroughly reviewed all policies on file with the Department. The letters sent to hospitals requested changes to hospitals’ policies. If your hospital received a letter, we encourage you to consider the proposed changes, consult legal counsel if necessary, and return an updated agreement to DOH as soon as possible. WSHA is pleased to see the Department taking a more active role in review and approval of charity policies. DOH maintains a website of all hospital charity care policies and state law requires hospitals to file a copy of their charity care policy with DOH. (Chelene Whiteaker, firstname.lastname@example.org)
WSHA Joins Healthier Hospitals Initiative
WSHA announced Monday that it has joined the Healthier Hospitals Initiative (HHI), a national campaign designed to lead change in the health care sector by helping hospitals adopt more sustainable practices in their day-to-day operations which can save health care dollars and improve the health of patients, employees, and community.
HHI works to reduce the environmental impact of hospitals by collecting and reporting data in at least one of six HHI Challenges: Engaged Leadership, Healthier Food, Leaner Energy, Less Waste, Safer Chemicals, and Smarter Purchasing. Each individual hospital can chose any or all of the six challenge areas in which to work. There is no cost to participating hospitals, although they are required to collect and report data relevant to the areas they are working in. (Mary Clunies-Ross, MaryKayCR@wsha.org)