Arkansas - Digital Publishing

part of the year-end fiscal cliff avoidance
package.
“We were certainly facing a challenge
up until that,” Morse said. “We were
looking at a reimbursement loss of about
$750,000, which represented our profit
for all of 2012. That would’ve moved us
into the red.”
Launched in 1990, MDH was established
to aid small rural hospitals. In
Arkansas, Baptist Health Medical Center
in Stuttgart, Hot Spring County Medical
Center in Malvern and NEA Baptist
Memorial Hospital in Jonesboro also
participate in the program.
The one-year extension of MDH
put $461,000 back in the 2013 budget
for Johnson County Regional Medical
Center.
Morse estimates the looming Medicaid
cut will hit hospital revenue somewhere
under $200,000 year.
“For our hospital, it’s a significant
amount of money, but we thought we
Impact of Medicare Payment Reductions
Facing Arkansas Hospitals as a Result
of the Affordable Care Act and Other Congressional Action
Estimated Medicare fee-for-service payment reductions to hospitals and post-acute
care providers based on recent payment changes authorized by Congress and regulatory
payment changes adopted (2013-2022)
Medicare Payment Rate Reductions 10-Year Impact 2013
Inpatient (operating and capital) ($925,146,700) ($28,301,600)
Outpatient ($293,702,300) ($3,577,000)
Inpatient rehabilitation facility ($97,265,000) ($1,185,200)
(hospital-based and free-standing)
Inpatient psychiatric facility ($40,610,300) ($511,600)
(hospital-based and free-standing)
Skilled nursing facility/swing bed (hospital-based) ($5,180,000) ($80,600)
Home health agency (hospital-based) ($80,083,400) ($1,157,600)
Long-term care hospital (free-standing) ($29,598,800) ($366,700)
Quality-Based Payment Changes ($180,474,600) ($7,577,400)
DSH Payment Reductions
Medicare DSH - inpatient ($385,131,100)
Medicaid DSH - inpatient
ACA Total negative impact ($2,037,192,200) ($38,512,300)
BCA 2 percent sequester ($407,258,700) ($42,677,800)
Middle Class Tax Relief and Job Creation Act
Bad Debt Payment Cuts ($17,354,600) ($1,017,800)
Total ($2,461,805,500) ($82,207,900)
This analysis shows the negative impact to Medicare fee-for-service (FFS) payments taking
into consideration the various and significant payment policy changes authorized by
the Affordable Care Act (ACA) of 2010, the effect of the 2.0% across-the-board reduction
to payments authorized by the Budget Control Act (BCA) of 2011 (sequestration), and the
reduction in bad debt payments authorized by the Middle Class Tax Relief and Job Creation
Act of 2012. The analysis also accounts for the known regulatory payment changes adopted
by the Centers for Medicare and Medicaid Services (CMS) for payment years 2013 and
beyond. This analysis does not capture ACA update factor cuts or regulatory coding adjustment
cuts implemented prior to 2013 that carry forward additional negative impacts in the
budget window analyzed.
Source: Arkansas Hospital Association.
could handle the additional 2 percent
Medicare cut,” he said.
“What we weren’t prepared for was
the major changes in payment rates for
insured patients. That’s projected to
reduce revenue by $350,000.”
While hospital revenue is getting
squeezed from a number of directions,
physicians gained another year of special
dispensation from substantial cuts
in Medicare reimbursement.
On paper, the accumulative
cut amounted
to somewhere around
29 percent, according to
David Wroten, execu-
David
Wroten
tive vice president of the
Arkansas Medical Society.
“As part of the bill
that was passed to avoid
the fiscal cliff, Congress put off physician
fee cuts for another year,” Wroten said.
“It’s status quo for 2013.” n
FISCAL CLIFF
We are pleased to announce the addition
of Corry Hull to our team. Corry joined our
Northwest Arkansas office as an Employee
Benefits Consultant. He is passionate about
understanding the changes going on in the
health care industry, and how it impacts our
clients’ businesses in the coming years.
Arkansas Business January 28, 2013 15
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EXPANDING OUR LEGACY
CORRY HULL