Hospital Reimbursement

Hospital payment cap slashes prices in Ore.

March 14, 2024 - An effort to reduce healthcare spending in Oregon has successfully lowered hospital prices and variation, according to a recent study in Health Affairs. Oregon implemented a cap on hospital prices in October 2019 and January 2020, when it applied the cap to members of the state’s employee health insurance plan. The policy capped hospital...


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Hospital Costs for Inpatient COVID-19 Treatment Rose 26% During Pandemic

by Victoria Bailey

The costs of providing inpatient COVID-19 treatment increased by 26 percent over the first two years of the pandemic, according to a study published in JAMA Network Open. Through the end of 2022,...

Hospitals Concerned About Medicaid State-Directed Payment Changes

by Jacqueline LaPointe

Eight leading healthcare industry groups are urging CMS to abandon proposed restrictions on provider-based Medicaid funding sources, citing coverage and cost consequences if the proposals are...

How Did Commercial Payments for COVID-19 Inpatient Stays Vary in 2020?

by Victoria Bailey

Commercial payments for inpatient stays associated with COVID-19 in 2020 were higher for health system-affiliated and high-quality hospitals, a study published in JAMA Health Forum found. When the...

Healthcare Services Cost More at Hospital Outpatient Departments

by Victoria Bailey

Costs for common medical procedures were up to 58 percent higher when they were performed in a hospital outpatient department compared to a doctor’s office, an analysis from the Blue Cross Blue...

AHA: Site-Neutral Payment Policies Hurt Hospitals

by Jacqueline LaPointe

As healthcare prices are put under the microscope, the American Hospital Association (AHA) is criticizing a cost-cutting method to reduce prices for outpatient services. The hospital group’s...

AHA Decries Inpatient Prospective Payment System Update

by Jacqueline LaPointe

The proposed market basket update in the Inpatient Prospective Payment System (IPPS) for the 2024 fiscal year (FY) is “woefully inadequate,” according to the American Hospital Association...

CMS Releases FY24 IPPS Proposed Rule, Seeks to Boost Rates by 2.8%

by Jacqueline LaPointe

CMS has released a proposed rule for the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS). The proposed rule would update hospital payment rates by 2.8 percent next fiscal year and...

Judge Wants HHS to Remedy 340B Underpayments to Hospitals

by Jacqueline LaPointe

A federal court has decided to let HHS determine how to repay hospitals for years of 340B underpayments. The decision issued Tuesday by the US District Court for the District of Columbia comes as a...

Financial Losses, Poor Assets Driving Closure Risks for Rural Hospitals

by Victoria Bailey

More than 600 rural hospitals are at risk of closing after consistently losing money on patient services and lacking net assets to offset these losses, according to data from the Center for Healthcare...

Study: Safety-Net Hospitals Miss Out on Some Medicaid DSH Payments

by Jacqueline LaPointe

Over a third of Medicaid disproportionate share hospital (DSH) payments may have been misallocated, according to a study led by Weill Cornell Medicine and University of Pennsylvania investigators. The...

AHA, AMA Urge Congress to Prevent Medicare PAYGO Sequester

by Victoria Bailey

Seven national healthcare organizations, including the American Hospital Association (AHA) and the American Medical Association (AMA), have asked Congress to prevent the Statutory Pay-As-You-Go (PAYGO)...

FAH Urges Congress to Pass Legislation to Limit Medicare Payment Cuts

by Victoria Bailey

As the 117th Congress nears the end of its session, the Federation of American Hospitals (FAH) has called upon congressional leaders to pass legislation that will reduce financial challenges for...

Hospital Reimbursement Boosts Access to Birth Control Postpartum

by Jacqueline LaPointe

A new study recently published in JAMA Network Open indicates that hospital reimbursement for immediate postpartum long-acting reversible contraception (LARC) leads to greater access to birth control...

CMS Will Apply Higher 340B Hospital Reimbursement Rate After Court Ruling

by Jacqueline LaPointe

Following a court order, CMS is revising its methodology for paying 340B hospitals for outpatient drugs and reprocessing claims paid on or before the Sept. 28th ruling. CMS will reimburse hospitals...

AHA Responds to Medicare Outpatient Payment Updates for CY 2023

by Victoria Bailey

When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American...

Social Risk Adjustment Reduced HRRP Penalties for Safety-Net Hospitals

by Victoria Bailey

Using social risk adjustment in Medicare’s Hospital Readmissions Reduction Program (HRRP) helped reduce differences in risk-adjusted readmissions and penalties between safety-net hospitals and...

AHA Asks Federal Court to Immediately Stop 340B Payment Cuts

by Jacqueline LaPointe

The American Hospital Association (AHA) has asked the US District Court for the District of Columbia to order HHS to immediately halt underpayments to hospitals participating in the 340B Drug Pricing...

CMS Releases FY23 IPPS Rule, Boosts Hospital Reimbursement by 4.3%

by Jacqueline LaPointe

CMS has released the Inpatient Prospective Payment System (IPPS) rule for fiscal year (FY) 2023, increasing hospital reimbursement by 4.3 percent and making good on promises to advance health equity....