Blog posts by Trahan Whitten

Defensible Provider Pricing in a Changing Environment

Wednesday, September 18th, 2013

Stethoscope with financial statement, calculator, penHospital pricing practices are under scrutiny as never before. Inspired by the activities of the Office of the Inspector General for the Medicare program, the House Energy and Commerce Committee, numerous class action lawsuits, legislation regarding pricing transparency, and, of course, the media, the hospital industry is under the microscope for an array of exaggerated and imagined offenses. Recent headlines include:

  • Affordable Care Act ruling (June 28, 2012)
  • Time magazine’s ‘Bitter Pill: Why Medical Bills are Killing Us’ (March 4, 2013)
  • Medicare data releases – inpatient (May 8, 2013) outpatient (June 3, 2013)
  • California Hospital Association press release states desire to move away from the chargemaster (May 8, 2013)
  • HFMA announces creation of a price transparency task force (June 18, 2013) (more…)

Updated SSI Ratios Decrease Medicare Payments to California Hospitals by $182 Million

Monday, July 9th, 2012

On March 15, CMS released the long awaited and updated Supplemental Security Income (SSI) ratios for Federal Fiscal Years (FFY) 2006 through 2009. HFS estimates the impact of the updated FFY 2006 through 2009 SSI ratios will decrease reimbursement by nearly $1 billion to the provider community, and over $182 million in California alone.

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$87,000,000 in Reimbursement Goes to Southern California Hospitals

Monday, May 2nd, 2011

Hospital Association of Southern California (HASC) & Consultants Team Up to Deliver $87,000,000 in Reimbursement to Southern California Hospitals

HASC and HFS teamed up again this year on the 2010 Wage Index Improvement Project (WIIP). Voluntary participation in the WIIP was requested from hospitals in Los Angeles, Orange County, Riverside, San Bernardino, Ventura, and Santa Barbara. HFS conducted a review of the filed wage index information and assisted participating hospitals to improve the accuracy of their reported average hourly wage information (AHW). (more…)

Medicare Wage Index Reducing the California Shortfall

Wednesday, November 10th, 2010

Issue
California hospitals face a potential $55 million reduction in Medicare payments because of a budget neutrality factor related to the rural wage index. Budget neutrality was achieved in the past through a national adjustment by which about 2,500 providers shared in “funding” neutrality. Now the potential reduction will be made on a state specific basis. Approximately 100 urban California hospitals, known as Rural Floor Recipients (RFRs) are paid, or will be paid, based on the rural wage index that is higher than their urban area (CBSA) index. This creates the need for a budget neutrality factor. Budget neutrality is “California only” and is “funded” by $39 million from non RFR urban providers, $1 million from rural providers and the remainder from the RFRs. An average increase of RFR wage rates of $1.50/hour would eliminate the California specific budget neutrality adjustment. (more…)

Section 1011 Reimbursement Opportunity

Saturday, September 18th, 2010

HFS is working in conjunction with BESLER Consulting to assist California providers recover revenue under Section 1011 (Public Law 108-173). Section 1011 is a Federal program that reimburses hospitals for care of undocumented aliens, certain paroled aliens and certain Mexican citizens permitted to enter the United States. Funds were not fully expended in Federal Years 2005 through 2008, and therefore the program was extended for all four quarters of Federal Year 2009. Following the payment of fourth quarter 2008 eligible claims which occurred in May 2009, California’s available funds totaled $128 million. (more…)

Generate $42 Million for its Membership

Monday, August 2nd, 2010

Generate $42 Million for its Membership
TRAHAN WHITTEN, Principal, Director of Government Programs & Reimbursement Services

In July, the Hospital Association of Southern California (HASC) Board approved the 2010 Wage Index Improvement Project (WIIP). HASC selected HFS Consultants to conduct the project that will help hospitals improve the accuracy of Average Hourly Wage (AHW) reporting in the HASC region. With broad hospital participation we should be able to generate an estimated $42 million in additional Medicare reimbursement for hospitals in the HASC region. The $42 million impact is based on a recent review of previously filed cost reports and represents an average 50¢ increase in the reported average hourly wage. (more…)

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