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June 5, 2013 MS Healthcare Executives Summer Meeting. Sustaining a Financially Vibrant Healthcare Organization. Panelists. Moderator – Gwen Combs VP for Policy & General Counsel, Mississippi Hospital Association
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MS Healthcare ExecutivesSummer Meeting
Sustaining a Financially Vibrant Healthcare Organization
Kevin Gore, CPA, BKD National Health Care Group
Critical Care: The Economic Impact of Hospitals on the State’s Economy
Source: 2007 MEDPAC report
By FFY 2015, hospitals will see reductions in payment, or no payment, for treatment of hospital acquired conditions. The newly proposed IPPS regulations from CMS indicate a 2% reduction in payment for those hospitals in the highest quartile for HACs.
By FFY 2015, hospitals that do not meet IQR requirements face a 2% reduction in reimbursement under newly proposed regulations.
The Middle Class Tax Relief and Job Creation Act of 2012 authorized reduction to Medicare payments for reimbursable bad debts for all provider settings to 65%.
Financial impact on Mississippi hospitals over 10 years is $37,001,400.
The American Taxpayer Relief Act of 2012 authorized coding adjustment cuts for inpatient claims and for outpatient radiosurgery claims.
Financial impact on Mississippi hospitals over 10 years is $123,512,800.
CMS imposed a prospective coding adjustment of 1.9% for FFY 2013. This coding adjustment continues under newly proposed regulations.
The financial impact on Mississippi hospitals is $246,752,400.
(if so, the state faces a lower reduction)
Under the Affordable Care Act, effective January 1, 2013, primary care physician reimbursement will be at 100% of Medicare, the difference being paid by the federal government for 2 years.
And don’t forget RACs, MACs, SMRCs, ZPIX, pre-payment reviews, utilization review, and prior authorization.
Follow or Lead?
How do hospitals maintain their financial viability in the face of the revolution and evolution of payment for hospital care and health care?