Finance and Reimbursement

Health Care Financing and Reimbursement
Public programs such as Medicare and Medicaid, as well as private payers continually look for ways to reduce the amount of money paid to providers for services that inextricably get more and more costly due to inflation and technological advances. These reductions or leveling in reimbursements, coupled with increasing numbers of uninsured and underinsured, create a difficult environment in which to meet the public's need for adequate, yet affordable health care.

Finance and Coverage Section of the 2009 Annual STAT Report
This bookmarked PDF contains data on finance trends in Kansas hospitals and in the nation. Health insurance premium and coverage data, as well as data on the uninsured can be found in this PDF.

Hospital Specific Information in the 2009 Annual STAT Report
This bookmarked PDF contains data on all Kansas hospital and their organizational structure, number of beds and utilization and medicare and medicaid utilization.

KHA Calendar

ACHE Congress - March 22-25

For more information, contact Melissa Hungerford or Susan Cunningham at (785) 233-7436.

KHA Board Meeting - March 24

For more information, contact Amy Fluke at (785) 233-7436.

KHA Infection Prevention Course - March 25

For more information, contact the KHA Education Department at (785) 233-7436 or ccarney@kha-net.org.

Aligning Interests Webinar - March 30

Compensation Models

KHSC Board Meeting - March 31

For more information, Lorri Dean or Steve Poage at (785) 233-7436.

Finance and Reimbursement

Hospital Finance

Hospitals in Kansas and across the nation have been working to develop fair and compassionate policies to help the uninsured and underinsured.

Hospital Reimbursement

For many Kansas health care organizations, government payment program beneficiaries represent a significant portion of the total patients served each year, and reimbursements for these programs comprise a significant percentage of revenues. KHA closely monitors state and federal budget provisions for these programs, as well as operational issues that affect its members. This site has been developed to provide information on various reimbursement topics that affect Kansas hospitals.

ARRA

The American Recovery and Reinvestment Act of 2009 includes several health related provisions that will have an impact on patients, providers, and purchasers. A large part of ARRA focused on provisions for the adoption of health information technology (HIT) and exchange (HIE) and electronic health records.

RAC

The Medicare Recovery Audit Contractor program is authorized by Congress to identify improper Medicare payments - both overpayments and underpayments. RACs are paid on a contingency fee basis, receiving a percentage of the improper payments they identify and collect. Following a three-year demonstration project, the law requires the Centers for Medicare and Medicaid Services to expand the program nationwide by 2010. The national expansion of the RACs is being introduced by region, with Kansas being slated sometime after August 2009.

Physician Supervision

Physician Supervision
In the 2009 Outpatient Prospective Payment System final rule, the Centers for Medicare and Medicaid Services issued what they called a "clarification and restatement" of an existing policy regarding physician supervision of outpatient therapeutic services that was in place since 2001. Since the adoption of that rule, KHA, AHA and other organizations have pointed out to CMS that their clarification was a change in Medicare policy. In the 2010 OPPS final rule, CMS made some changes, but the changes have not gone far enough. This site contains documents explaining the concerns voiced by member hospitals, as well as a log of actions taken by KHA.