Hospital News: Insurer Negotiations, Exemptions At Risk, And Florida Money Trouble
Hospitals are pushing for higher reimbursement rates in some cases, raises of more than 20 percent and insurers are increasingly fighting back, The Wall Street Journal reports. "Hospitals argue that low Medicare rates and cuts to Medicaid mean that hospitals have to get money from elsewhere, and increasingly that is private insurers. Rising ranks of uninsured Americans have led to more uncompensated care and have swelled the rolls of Medicaid, exacerbating the problem. But insurers contend that in recent years big hospital systems have been buying up smaller medical centers and using their dominance in a region to demand big rate increases."
For example, insurer Aetna typically agreed to 5 percent increases with hospitals five years ago; "this year Aetna granted 50 'must have' rate increases of more than 20%" (Johnson and Sataline, 3/19).
KHN has a related story in today's Research Roundup.
Also in hospital news, an "Illinois Supreme Court decision Thursday puts nonprofit hospitals on notice that they must provide an adequate amount of charity care to patients or risk losing significant tax exemptions," according to the Chicago Tribune. The decision upholds an earlier warning in a lower court (Jaspen and Grotto, 3/19).
And, in Florida, "[a]fter warning two weeks ago that it would run out of money within weeks, Miami's public hospital group has cobbled together a stabilization plan that will keep most services intact through the end of September," The New York Times reports. Under the just-approved plan, Jackson Health System would "cut 655 positions, delay debt payments and, if possible, exact $30 million in concessions from unions" (Cave, 3/18).