*Several of our members were not able to open the “accordion”.  These reports are presented here for them.  Contact Data Team if you have questions.

MRI/GAP Plan Payments (March 2021)

Cumulative Risk Analysis (March 2021)

Managed Care Analysis (March 2021)

Managed Care Information (updated June 2021)

Medicaid Expansion 1-year Impact Analysis (March 2021)

Update: HHS announced the distribution of $10 billion in CARES Act Provider Relief Funds to certain Safety Net hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care. According to the HHS announcement, hospitals qualifying for this funding pool will have:

· a Medicare Disproportionate Payment Percentage of 20.2% or greater;
· average uncompensated care of $25,000 or more per bed — for example, a hospital with 100 beds would need to provide $2,500,000 in uncompensated care in a
year to meet this requirement; and
· profitability of 3% or less, as reported to CMS in the hospital’s most recently filed cost report.

Updated June 11, 2020

Update: Health and Human Services began distribution of the $10 billion COVID-19 relief to rural providers. Hospitals and Rural Health Clinics will each receive a minimum base payment plus a percent of their annual operating expenses. This expense-based method accounts for operating cost and lost revenue incurred by rural hospitals for both inpatient and outpatient services. The base payment will account for RHCs with no reported Medicare claims, such as pediatric RHCs, and Community Health Centers lacking expense data, by ensuring that all clinical, non-hospital sites receive a minimum level of support no less than $100,000, with additional payment based on operating expenses. Rural acute care general hospitals and CAHs will receive a minimum level of support of no less than $1,000,000, with additional payment based on operating expenses.

Updated May 11, 2020.

Update: Health and Human Services began distribution to providers of the remaining $20 billion of the $50 billion general allocation on April 24. Payment to providers from this $20 billion are calculated so that a provider’s allocation from the entire $50 billion general distribution is a portion of such provider’s 2018 net patient revenue. Total revenues of Medicare facilities and providers is estimated to be approximately $2.5 trillion. Providers can estimate their expected combined general revenue distribution through the following formula: Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.

Updated April 26, 2020.

Please Note: Several payment changes adopted in the CARES Act are not included due to lack of data and/or full detail on implementation. For other impacts, such as Medicaid DSH, please contact Anthony Okunak (aokunak@ncha.org).

On March 27, 2020, Congress responded to the COVID-19 emergency by adopting the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The act provides financial relief and resources to hospitals impacted by the public health emergency. This analysis indicates how existing Medicare provider payments will be affected by the CARES Act legislation.

Updated April 2020.

Critical Access and Small and Rural Hospitals PPS Databook

The Critical Access and Small Rural Prospective Payment System (PPS) Hospitals DataBook is intended to provide hospitals with a comprehensive and comparative review of:

Updated November 2020.

Medicare VBP Estimates for Critical Access Hospitals

This analysis is intended to provide CAHs with an estimate of their performance potential under a scenario for the CAH VBP program that closely resembles the one currently in place for IPPS hospitals.  The reports in this analysis estimate VBP scores and impacts for CAHs, and provide full detail on how the points and scores for each quality measure and quality domain are calculated.

Updated September 2020.