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Friday, July 7, 2023

Hospitals with Health Equity Factors Face Value-Based Penalties

 

Some hospitals with more medically complex patients, uncompensated care, and patients who live alone are more likely to receive a penalty under CMS value-based payment programs, according to a new study calling for change to the programs.


Larger hospitals, major teaching hospitals, and some hospital groups with higher disproportionate share hospital (DSH) percentages were more likely to be penalized in fiscal year (FY) 2015 and FY 2021, according to an analysis. This was especially true in the Hospital VBP Program.


Hospitals with the highest relative portion of uncompensated care cost were somewhat more likely to receive penalties.


Another very big problem hospitals struggle with are underpayments by insurers. GMG has the software (not for sale) to recoup these millions of dollars!


Access Discount Healthcare Underpayment Recovery for Hospitals, Urgent Cares and Large Primary Care shown program is now active (see sample from just 4 of the 712+ facilities that have enrolled.)


Email me for details:

Larry G. Potter

Lgpotter33@gmail.com




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