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.
Medicaid Managed Care Delivery System
On July 1, 2021 North Carolina’s Medicaid program transitioned from a fee-for-service (FFS) delivery system to a managed care delivery system. This delivery system is drastically different from the previous FFS system. As such, NCHA has created a webpage to assist members with the transition. Click to view page…
MRI/GAP Plan Payments
Includes a detailed schedule of the impact of the latest MRI/GAP plan transactions. The latest model is the 2021 true up.
View Member Report(s)
2021 Cumulative Risk Analysis
Details state and federal policies that are expected to impact North Carolina hospitals in 2021. Estimates are provided at the hospital, system and state level.
View Member Report(s)
2021 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.
Managed Care Information
Hospital-specific information regarding Managed Care assessments and outpatient laboratory service impacts.
View Member Report(s)
2021 Medicaid Expansion Analysis
Details the financial impact to hospitals in the scenario of Medicaid Expansion in North Carolina.
View Member Report(s)
Federal Analyses – DataGen Reports
NCHA contracts with the Hospital Association of New York State (HANYS) to offer DataGen reports to members.
DataGen reports:
Interpret changes in healthcare payment policy.
Model the impact of healthcare payment changes on revenue, quality, and profitability.
Help members to act on insight to drive organizational change.
NCHA Staff Contact
Jeffrey Weegar, CPA
Vice President
Financial Policy
919-677-4231
jweegar@ncha.org
Ronnie Cook, CPA
Consultant
Finance & Managed Care
919-677-4225
rcook@ncha.org
North Carolina Healthcare Association