As Reimbursement Declines, What Leadership Qualities are Most Important?

During discussions about the Affordable Care Act over the past few years, we’ve assumed that hospitals, generally, have supported the landmark healthcare reform legislation. The expansion of insurance coverage to more people, reduces the amount of uncompensated care.

 

Editor's Note: This article originally appeared on Select International's website.

What many people have missed, however, is that the Affordable Care Act, and other regulatory and market changes have continued to decrease the actual reimbursement hospitals receive for the care they provide. From a recent summary of the situation:

  • Payments to hospitals will be reduced by $218.2 billion by 2028.
  • The cuts include $79.3 billion for Medicare Severity Diagnosis Related Groups (MS-DRG) documentation and coding, $73.1 billion for sequestration, and $25.9 billion for Medicaid Disproportionate Share Hospital (DSH) payments.
  • Medicare margins are hitting a 10-year low; and
  • Nearly one-third of hospitals have negative aggregate margins across all payer types.

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