Financial Services

NCHA Financial Services staff help members navigate the ongoing changes in healthcare finance while protecting funding and reimbursement. As demands increase to control expenditures in an environment of new regulations and evolving reimbursement methods, members can rely on NCHA’s financial services for information and guidance to stay viable.

The association often represents members’ financial interests before federal and state regulatory agencies and third-party payers. The staff also manages the Medicaid Reimbursement Initiative/Gap Assessment Program and convenes workgroups with members to work on issues related to government and commercial payers.

Managed Care Analysis

The Medicaid Managed Care Analysis shows the potential hospital reimbursement impact as a result of North Carolina switching from a Medicaid fee-for-service (FFS) delivery system to a Medicaid managed care delivery system. The analysis allows hospitals to adjust key inputs that impact hospital reimbursement in Medicaid managed care. Key inputs include utilization trends, cost inflation, denial rates, etc.

Hospital Base Rates

Hospital-specific base rate calculations for inpatient DRG and outpatient RCC and rehabilitation-specific base rate calculations.
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