WSHA provides hospital analyses: Review needed on occupation mix data, WSHA needs impacts of proposed cuts to 340B drugs, off-campus hospital services

August 9, 2017

WSHA recently sent three hospital-specific reports to the chief financial officer at each of our member hospitals. The reports include:

  • The Outpatient Prospective Payment System (OPPS) Calendar Year (CY) 2018 Proposed Rule Analysis shows providers how Medicare outpatient payments may change from CY 2017 to CY 2018 based on the policies suggested in the 2018 proposed rule. In aggregate, Washington hospitals paid under OPPS will experience a payment increase of 1.69 percent, with hospital-specific impact for most hospitals ranging from about zero to 3.5 percent. This does not reflect the additional two percent sequestration reduction to payment authorized by Congress through 2025.

WSHA plans to comment on CMS’ proposed rules before the comment deadline of September 11. To assist us in our comments, if you are a 340B hospital or operate newer off-campus hospital services (after November 2015), please let us know what financial impact these cuts would have on your hospital’s ability to provide services to underserved patients and locations. Because of limitations of the data source used for the analysis, the report does not estimate the impact of the proposed 25 percent reduction to payments for drugs provided by 340B eligible hospitals.  It also does not reflect the impact of the proposed additional 50 percent cut for services provided by off-campus hospital department locations and services established after October 2015. The cut to off-campus hospital locations is in the proposed Medicare Physician Fee Schedule (MPFS) rule. Please send comments to Andrew Busz at andrewb@wsha.org.

The Financial Indicators Analysis provides all-payer comparative financial ratios/metrics for hospitals compared to various benchmark groups for twelve financial ratios/indicators. The financial ratios shown are calculated using standard accepted formulas, as defined by various ratings agencies.

  • The Medicare Hospital Occupational Mix Data Analysis–Preliminary Data (Review Needed) provides hospitals with a comparative review of the occupational mix data that will be used to develop the federal fiscal year (FFY) 2019 Medicare hospital wage index. It is extremely important that hospitals review their occupational mix data. Hospitals have until September 1, 2017 to request revisions to their data. Subsequent opportunities for correction can only address Fiscal Intermediary (FI) / Medicare Administrative Contractor (MAC) mishandling of the data. Requests and supporting documentation for revision requests must be submitted to the hospital’s FI/MAC.

If you have questions on any of these reports, please contact Andrea Palmiter at andreapa@wsha.org  or Andrew Busz at andrewb@wsha.org

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