IHA Daily Briefing: May 14

Monday, May 14, 2018

IHA Sends Assessment Redesign Letter to CMS
Gallup: Uninsured Rate Increased in 2017
New Charts Analyze U.S. Healthcare Prices
Register Now: Unpatrolled Revenue Integrity Training
Briefly Noted

IHA Sends Assessment Redesign Letter to CMS
Late last week, IHA sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma in support of the redesigned Illinois Hospital Assessment Program. The letter comes a week after the entire Illinois Congressional Delegation sent its own letter to the agency asking for an expedited approval of the plan.

In the letter, IHA Board of Trustees Chair William Santulli, chief operating officer, Advocate Aurora Health, and IHA President & CEO A.J. Wilhelmi point out that Illinois’ state plan amendment for the redesigned program includes significant reforms to the current program:

“First, the plan updates patient utilization data for the first time in over 10 years reflecting the Medicaid program and its beneficiaries as it exists today. The program also shifts significant amounts of payments to a more dynamic system that more closely aligns reimbursement with actual services provided to Medicaid beneficiaries. Illinois hospitals have been at the forefront of transforming the way care is delivered in our state. The hospital assessment program seeks to provide a stable pathway to help support hospitals as they continue to transform to best meet the needs of their communities.”

The letter also highlights the outcome of months of negotiations with the Illinois Department of Healthcare and Family Services and legislative leaders to achieve a hospital assessment redesign that received overwhelming bipartisan support at the state and federal levels. The letter serves to demonstrate to CMS the hospital industry’s support for the assessment program and urges CMS to approve the state’s plan.


Gallup: Uninsured Rate Increased in 2017
Findings released last week from a Gallup report showed that the 2017 uninsured rate rose in 17 states, including Illinois. According to Gallup, the uninsured rate rose to 12.2 percent nationwide in fourth quarter 2017, up 1.3 percent from 2016. Illinois’ uninsured rate went up to 9.3 percent, up 1.6 percent from 2016.

Ten of the 17 states that experienced a rise in the uninsured rate also were Medicaid expansion states. Gallup reported the uninsured rate among all Medicaid expansion states in 2017 was 9.1 percent, up from 8.2 percent in 2016.

Nationally, Massachusetts had the lowest overall uninsured rate in 2017 at 4 percent, and has had the lowest uninsured rate overall for the past 10 years. On the flip side, Texas had the highest uninsured rate in 2017 at 22.5 percent, and has had the highest uninsured rate in the nation for the past 10 years.


New Charts Analyze U.S. Healthcare Prices
As part of a forum on healthcare prices this week, the Kaiser Family Foundation and the Peterson Center on Healthcare released two new chart collections, one analyzing trends in U.S. healthcare prices and utilization and one comparing U.S. health spending with that of other high-income countries.

How Have Healthcare Prices Grown in the U.S. Over Time shows that prices have increased for a variety of health services more rapidly than general economic inflation, particularly for the privately insured. Additionally, it reveals wide geographic variation in the prices paid for the same services across major metropolitan areas. For example, the average price for a lower-back MRI in the Chicago area ($1,123) is more than twice the average price in the Baltimore, Maryland or Farmington Hills, Michigan areas. The national average is $894.

How Do Healthcare Prices and Use in the U.S. Compare to Other Countries finds that higher prices for most healthcare services and prescription drugs – more so than utilization – explain high health spending in the U.S. relative to other high-income countries. Utilization of several services, including physician consultations and hospital stays, is lower in the U.S. than in many comparable countries. According to the charts, despite having fewer office visits and shorter average hospital stays, the U.S. overall spends twice as much per person on healthcare than do comparable countries.


Register Now: Unpatrolled Revenue Integrity Training
Send a team from your organization to join colleagues from across Illinois at an intensive four-day course on reducing compliance risk, minimizing revenue leakage and overcoming reimbursement struggles. Held July 23-26, the HCPro Revenue Integrity and Chargemaster Boot Camp® will help participants relate chargemaster maintenance and functions to cost reporting, revenue integrity processes and key operational issues such as clinical documentation, charge capture and health information management (HIM) coding. These critical insights can help teams avoid denials and improve clean claim rates.

For more information about session topics, expert faculty, fees, continuing education credits, and registration, click here.


Briefly Noted
The Centers for Medicaid and Medicare Services (CMS) has released its updated Geographic Variation Public Use File with data for 2007-2016. The file has a series of downloadable tables and reports that contain demographic, spending, utilization, and quality indicators for the Medicare fee-for-service population, at various geographic levels.