BWC
Background and updates on health care coverage and payment policies and procedures that support BWC's Health Partnership Program and Ohio self-insured employers.
Since 1912, the Ohio Bureau of Workers’ Compensation (BWC) has provided medical and compensation benefits for work-related injuries, diseases and deaths. BWC provides insurance to about two-thirds of Ohio's work force. The remaining workers receive coverage directly through their self-insured employers. BWC is the largest exclusive state-fund workers’ compensation system in the United States and the second largest underwriter of workers’ compensation insurance in the country. Ohio’s workers’ compensation system is made up of two parts: BWC, the administrative and insurance arm of the system, and the Industrial Commission of Ohio, the claims adjudicative arm.
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BWC To Delay Hospital OPPS
February 26, 2010:
The Ohio Bureau of Workers' Compensation (BWC) will delay the start of its transition to a hospital outpatient prospective payment system (OPPS) until 2011, citing complaints from OHA and a number of member hospitals about the negative effects of the proposed BWC OPPS on 2010 budgets.
Last summer, BWC unveiled a plan to adopt the Medicare OPPS as its payment methodology for outpatient hospital services for the state-fund Health Partnership Program (HPP), effective April 2010. BWC also announced its intention to cut $30 million a year in state-fund outpatient hospital payments by setting the BWC OPPS rate at 166 percent of what Medicare pays for the same service at a general acute care hospital and 253 percent of the Medicare rate at a childrens' hospital. Critical access hospitals would be exempt from the BWC OPPS, just as they are from Medicare's.
OHA's Finance Committee opposed the move in a series of meetings with BWC staff, protesting that the imposition of an OPPS is unnecessary, overly expensive and, in conjunction with planned payment cut, highly redistributive within hospitals and systems. BWC insisted its OPPS plan was sound and cost effective, but initially responded to OHA by bumping the implementation back one month and adding a two-year transition, during which hospital payments would be based on a blend of old and new payment systems.
At this point, however, while still defending its decision to move to an OPPS, BWC states it will compromise with hospitals concerned about meeting 2010 budgetary targets set before the bureau's plans were finalized by holding off on OPPS until Winter 2011, and then starting the promised two-year transition, which will push full OPPS implementation back to 2013. OHA will follow the story as it develops and report again when additional details are released.