/ en Thu, 01 May 2025 14:10:45 -0500 Thu, 10 Apr 25 14:39:27 -0500 /news/headline/2025-04-10-coalition-ad-highlights-impacts-potential-medicaid-cuts-children <p>The Coalition to Strengthen America’s Healthcare today launched a <a href="https://www.youtube.com/watch?v=qAglo-JZzdY&t=1s" title="Coalition ad">new television and digital advertisement</a> as part of its Medicaid campaign. The ad highlights the impacts Medicaid cuts would have on the more than 30 million children who rely on the program for care. Viewers are called on to urge Congress not to cut Medicaid funding.   <br>   <br>The AHA is a founding member of the Coalition.</p> Thu, 10 Apr 2025 14:39:27 -0500 Paying for Health Care /news/headline/2025-03-10-house-expected-consider-cr-fund-government-through-sept-30-extend-key-health-care-provisions <p>House Republican leaders March 8 unveiled a <a href="https://rules.house.gov/sites/evo-subsites/rules.house.gov/files/documents/crfull_xml.pdf" title="House extender bill">bill</a> that would fund the federal government through Sept. 30 of this year, as well as extend certain key health care provisions that are set to expire at the end of March. The bill, known as a continuing resolution, would largely keep government funding at current levels through the end of this fiscal year, with some adjustments. Current government funding is set to expire March 14. </p><p>The House Rules Committee is expected to consider the bill today, and it could be on the House floor for a vote on March 11. If it passes the House, it is expected to be on the Senate floor later this week.</p><p>Some key highlights of health care provisions include: </p><ul><li><strong>Medicaid Disproportionate Share Hospital Relief. </strong>The bill would eliminate the Medicaid DSH cuts through Sept. 30, 2025.   </li><li><strong>Medicare Rural Extenders. </strong>The bill would extend the enhanced low-volume adjustment program through Sept. 30, 2025, and the Medicare-dependent hospital program through Oct. 1, 2025.</li><li><strong>Medicare Telehealth and Hospital-at-home Extensions. </strong>The bill would extend key telehealth waivers and the hospital-at-home program through Sept. 30, 2025.</li><li><strong>Extension of the Work Geographic Index Floor under the Medicare Program. </strong>The bill will extend a 1.0 floor on the work geographic practice cost index through Oct. 1, 2025.</li><li><strong>Medicare Rural Ambulance.</strong> The bill will extend add-on payments for ambulance services through Oct. 1, 2025. These add-on payments support rural, “super-rural” and urban ambulance services. </li></ul> Mon, 10 Mar 2025 14:43:08 -0500 Paying for Health Care /news/headline/2025-01-16-medpac-recommends-congress-medicare-2026-payment-updates-inpatient-outpatient-services <p>The Medicare Payment Advisory Commission today voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% for 2026 and reiterated its recommendation to distribute an additional $4 billion to safety-net hospitals by transitioning to a Medicare safety-net index policy. The AHA <a href="/2025-01-10-aha-comments-advance-medpac-january-2025-meeting?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today" title="medpac policy">last week urged</a> the committee for higher updates.  <br> <br>In other action, MedPAC recommended that Congress update 2026 Medicare payments for physicians and other health professional services by the Medicare Economic Index minus one percentage and enact a non-budget-neutral add-on payment under the physician fee schedule to services provided to low-income Medicare beneficiaries. The commission also recommended reducing the 2026 payment rates for home health agencies by 7%, skilled nursing facilities by 3% and inpatient rehabilitation facilities by 7%. </p><p>In addition, MedPAC voted to recommend eliminating the 190-day lifetime limit in freestanding inpatient psychiatric facilities and the reduction of the number of covered inpatient psychiatric days. The commission also presented status reports for the Part D program and ambulatory surgical centers.  </p><p>In a public meeting scheduled for Jan. 17, the commission expects to discuss the status of the Medicare Advantage program, along with beneficiary cost-sharing for outpatient services at critical access hospitals.</p> Thu, 16 Jan 2025 15:58:40 -0600 Paying for Health Care /news/headline/2024-12-13-medpac-discusses-2026-draft-payment-update-recommendations <div><p paraid="1737042353" paraeid="{deea1fd4-cce4-4206-8875-0b4e6e517ac3}{79}">The Medicare Payment Advisory Commission Dec. 12 and 13 discussed draft payment update recommendations for 2026, which the commission will vote on in January. The draft recommendations call for Congress to update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% and transition to a safety-net index policy to distribute an additional $4 billion to safety-net hospitals.  </p></div><div><p paraid="828199509" paraeid="{deea1fd4-cce4-4206-8875-0b4e6e517ac3}{93}">They also propose that Congress update 2026 Medicare base payments for physicians and other health professional services by the projected increase in the Medicare Economic Index minus 1% and enact safety net add-on payments for services delivered to low-income Medicare beneficiaries. In addition, the commission proposes to reduce the 2026 payment rate for inpatient rehabilitation facilities by 7%, home health agencies by 7%, and skilled nursing facilities by 3%.</p></div> Fri, 13 Dec 2024 13:25:39 -0600 Paying for Health Care /news/headline/2024-07-19-caqh-launches-2024-indexing-survey-tracking-trends-electronic-administrative-transactions <p>The Council for Affordable Quality Healthcare has launched its annual indexing survey for 2024, which tracks trends in the adoption of electronic transactions for routine administrative interactions between health care providers and health plans. It estimates potential cost and time savings associated with changing from manual to electronic transactions and costs avoided through automation. Hospitals and health systems can complete the survey <a href="https://norc.az1.qualtrics.com/jfe/form/SV_0ARn96kHhZEYHRA">online</a> or download a printable version. Participants must complete the survey by Aug. 31. Submitted data will be confidential and reported data will be deidentified.</p> Fri, 19 Jul 2024 14:56:31 -0500 Paying for Health Care /news/headline/2024-06-25-aha-responds-study-blaming-hospital-prices-societal-issues <p>In a blog published June 24, the AHA responded to a study blaming hospital prices for a host of societal issues, including job losses outside of health care and increased suicide rates. The study, funded by Arnold Ventures, was highlighted in a Wall Street Journal <a href="https://www.wsj.com/health/healthcare/hospital-healthcare-prices-increase-employee-layoffs-9a4b90f6">article</a>. <br> <br>“To be clear: Hospital prices do not cause suicide,” AHA wrote. “No single thing does. Indeed, the hospital is – or should be – a place of last resort for individuals in need of ongoing psychiatric care. And hospitals are the only part of the health care system that are open 24 hours a day, 7 days a week to be there when needed, regardless of whether someone has insurance or the ability to pay. We wish we did not have to make such an obvious point, but the weakness of this research compels us to. Perhaps Arnold Ventures should have directed this funding to research on how to reduce suicide rather than a shoddy attack on those who treat behavioral health problems every day.” <a href="/news/blog/2024-06-24-setting-record-straight-latest-arnold-ventures-funded-study-draws-many-faulty-conclusions-including?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today">READ MORE</a> </p> Tue, 25 Jun 2024 16:09:03 -0500 Paying for Health Care /news/headline/2023-06-28-aha-comments-cms-proposals-review-medicaid-chip-payment-and-access-challenges <p>Commenting yesterday on two major proposed rules related to access, finance and quality in the Medicaid and Children’s Health Insurance Program managed care and fee-for-service delivery systems, AHA told the Centers for Medicare & Medicaid Services the wide-ranging regulations advance many important policies that will reshape the regulatory landscape for the Medicaid and CHIP programs. <br />  <br /> With regard to the managed care rule, however, AHA expressed <a href="/lettercomment/2023-06-28-aha-letter-cms-proposed-medicaid-and-chip-access-finance-and-quality-policies" target="_blank">concern</a> that certain policies may jeopardize states’ access to critical financial resources, especially CMS’ proposal to further restrict state sources of Medicaid financing and use hospitals to enforce compliance with CMS’s policy positions through new attestation requirements. AHA also encouraged CMS to adopt the average commercial rate as the upper payment for state-directed payments to hospitals, opposing any more restrictive upper payment approaches.  <br />  <br /> AHA <a href="/lettercomment/2023-06-28-aha-comment-letter-cms-proposed-rule-ensure-medicaid-services-access" target="_blank">applauded</a> CMS’ proposals to increase transparency in provider payment rates, expand stakeholder and beneficiary engagement, and improve access to home and community-based services in the FFS delivery system. Among specific concerns, AHA said it supports requiring states to evaluate and disclose how rates for certain critical services compare to Medicare FFS rates, but cautioned against assuming that Medicare FFS rates are adequate. “Indeed, Medicare underpayments of providers in 2020 totaled more than $75 billion. Instead, this analysis should be viewed as one piece of information as policymakers and stakeholders evaluate the impact of provider payment on beneficiary access to care.”   <br />  <br /> Comments on both rules are due to CMS by July 3.</p> Wed, 28 Jun 2023 14:50:42 -0500 Paying for Health Care /news/headline/2023-01-13-medpac-adopts-payment-recommendations-2024 <p>The Medicare Payment Advisory Commission today voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1% for 2024, and distribute an additional $2 billion to safety-net hospitals by transitioning to a safety-net index policy. In other action, MedPAC recommended that Congress: </p> <ul> <li>Update 2024 Medicare payments for physicians and other health professional services by half the Medicare Economic Index increase, and enact a non-budget-neutral add-on payment under the physician fee schedule to services provided to low-income Medicare beneficiaries.</li> <li>Reduce 2024 payment rate for home health agencies by 7%.</li> <li>Reduce 2024 payment rates for skilled nursing facilities and inpatient rehabilitation facilities by 3%.</li> <li>Update the 2024 Medicare base payment rate for hospice services by the amount specified in current law, and wage adjust and reduce the hospice aggregate cap by 20%.</li> </ul> <p>In addition, MedPAC presented status reports for the Part D and Medicare Advantage programs, and reports on outpatient use of behavioral health services and telehealth. The commission also reviewed three policy approaches to addressing high Part B drug prices, a body of work it will continue this spring.</p> Fri, 13 Jan 2023 14:30:19 -0600 Paying for Health Care /news/headline/2022-11-14-congress-urged-prevent-additional-paygo-cuts-medicare <p>The AHA and seven other national hospital organizations today urged congressional leaders to waive the Statutory PAYGO sequester before yearend to prevent nearly $10 billion in estimated cuts next year to hospital providers in fee-for-service Medicare.</p> <p>“And this would be on top of the 2% Medicare sequester cuts, which had been waived for part of the pandemic, but are back in full effect as of July 1, 2022,” the <a href="/lettercomment/2022-11-14-aha-health-care-providers-congressional-leaders-prevent-statutory-pay-you-go-sequester-taking-effect" target="_blank">groups wrote</a>. “We appreciate that Congress has never allowed Statutory PAYGO cuts to go into effect, and we urge Congress to again act before the end of this year to prevent the reductions from occurring. <strong>Additional Medicare reductions to providers are not sustainable and put at risk our members’ ability to care for their patients.”</strong></p> Mon, 14 Nov 2022 14:41:13 -0600 Paying for Health Care /guidesreports/2022-09-15-current-state-hospital-finances-fall-2022-update <div class="container"> <div class="row"> <div class="col-md-8"> <p>Since the onset of the COVID 19 pandemic in March 2020, our nation’s hospitals and health systems have coped with intense pressure on staff and resources.</p> <p>As hospital executives, policymakers, and other stakeholders assess the current landscape, key findings about recent and projected future performance through the rest of 2022 include:</p> <ul> <li><span><strong>Margins remain depressed relative to pre-pandemic levels.</strong></span> After a difficult first half of 2022, optimistic projections for the rest of the year indicate margins will be down 37% relative to pre-pandemic levels.</li> <li><span><strong>More than half of hospitals are projected to have negative margins through 2022.</strong></span> Projections for the remainder of the year demonstrate an increase in hospitals with negative margins relative to pre-pandemic levels, to 53%.</li> <li><span><strong>Expenses are significantly elevated from pre-pandemic levels.</strong></span> Expenses are projected to increase throughout the rest of 2022, leading to an increase of nearly $135 billion over 2021 levels. Labor expenses are projected to increase by $86 billion, while non-labor expenses are projected to increase by $49 billion.</li> <li><span><strong>Hospitals have faced a profound financial toll.</strong></span> Hospitals have incurred serious losses in 2022 relative to pre-pandemic levels and future federal support is uncertain.</li> </ul> <p>Hospitals also are facing a host of other related challenges, including workforce shortages, supply disruptions, and rising expenses.</p> <p><span><strong>Ultimately, U.S. hospitals are likely to face billions of dollars in losses in 2022 under both optimistic and pessimistic models,</strong></span> which would result in the most difficult year for hospitals and health systems since the beginning of the pandemic with no foreseeable federal support.</p> <p>These findings underscore the broad and serious threats America’s hospitals have faced and continue to face in 2022 caring for their communities throughout unprecedented challenges.</p> <p><strong><em><a href="/system/files/media/file/2022/09/The-Current-State-of-Hospital-Finances-Fall-2022-Update-KaufmanHall.pdf" target="_blank" title="Click here to download the The Current State of Hospital Finances: Fall 2022 Update PDF.">Read the full report.</a></em></strong></p> </div> <div class="col-md-4"><a href="/system/files/media/file/2022/09/The-Current-State-of-Hospital-Finances-Fall-2022-Update-KaufmanHall.pdf" target="_blank" title="Click here to download the The Current State of Hospital Finances: Fall 2022 Update PDF."><img alt="The Current State of Hospital Finances: Fall 2022 Update page 1. KaufmanHall. ©2022 Kaufman, Hall & Associates, LLC. All rights reserved." data-entity-type="file" data-entity-uuid="c39b1a13-532e-4c6c-83a3-7319f95dffcf" src="/sites/default/files/inline-images/Page-1-The-Current-State-of-Hospital-Finances-Fall-2022-Update.png" width="900" height="506"></a> <hr> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/press-releases/2022-09-15-new-report-shows-2022-will-be-most-financially-difficult-hospitals-and" target="_blank" title="Click here to view the press release New Report Shows 2022 Will be the Most Financially Difficult for Hospitals and Health Systems Since the Start of Pandemic.">Press Release: New Report Shows 2022 Will be the Most Financially Difficult for Hospitals and Health Systems Since the Start of Pandemic</a></div> </div> </div> </div> ul li::before { color: #003087; /* Change the color */ } Thu, 15 Sep 2022 06:00:00 -0500 Paying for Health Care