A CMS program meant to spice up reimbursement in areas the place healthcare suppliers pay the bottom worker wages might not be centered on the hospitals that the majority want the added funds, in line with a brand new federal audit.
HHS’ Workplace of Inspector Common on Wednesday recommended the hospital wage index shoud goal rural hospitals and suppliers working at low or damaging margins. The report discovered rural hospitals had the very best focus of low-wage suppliers, which accounted for 53% of all suppliers within the backside the 25th percentile.
Twenty-four states accounted for 866 of hospitals within the lowest wage quartile, in line with the report. Puerto Rico and 5 states—Alabama, Arkansas, Louisiana, Mississippi and West Virginia—had been house to 358 of these hospitals. Greater than 90% of these states’ hospitals had been within the lowest quartile of the hospital wage index.
Final August, CMS issued last rule adjustments to its acute-care hospital inpatient potential fee system that included readjustments in the way in which the company calculates its hospital wage index, which CMS makes use of to regulate Medicare fee charges to raised mirror wages supplied in native labor markets.
The rule change will improve the wage index amongst hospitals beneath the 25th percentile wage index worth starting in fiscal 2020 for not less than the following 4 years in an effort to slim the wage disparity between low-wage and higher-wage suppliers.
“The Trump administration is offering reduction to rural communities and addressing fee insurance policies which have deprived rural hospitals, making it more durable for them to remain open and supply care to the one in 5 Individuals dwelling in rural areas,” CMS Administrator Seema Verma stated in a press release when the rule adjustments had been introduced.
States with hospitals within the backside quartile for worker wages additionally had the bottom state minimal wage quantities, with 17 solely assembly the federal minimal wage of $7.25 an hour. No state that had a hospital within the backside quartile had a minimal wage above $eight.75.
Greater than half of the hospitals within the backside quartile had been situated in states that didn’t broaden Medicaid for all adults incomes as much as 138% of the federal poverty stage.
Whereas states with hospitals on the backside for wages shared many widespread traits, the report discovered quite a lot of variation when it comes to their fiscal efficiency. Revenue margins amongst hospitals with wage index values within the backside quartile ranged from a low of damaging 133% to a internet optimistic of 47%.
The report discovered giant disparities within the common hourly wages of particular person suppliers situated inside space wage indexes. In Kentucky, the common hourly wage for acute-care hospitals within the backside quartile spanned from $44 an hour to $25 an hour.
“CMS might think about finding out why some hospitals in a specific space had been in a position to pay greater wages than different hospitals in the identical space, previous to the implementation of the underside quartile wage index adjustment,” in line with the report.
The inspector basic report really helpful CMS monitor wage information over the brand new few years to find out whether or not wage will increase are occurring on account of the wage index adjustment however acknowledged the influence within the first yr might not be seen because of the monetary influence of the COVID-19 pandemic.