MEDICARE PAYMENT STUDY
 

Annually, OHA evaluates Medicare payments and costs to Ohio hospitals. This analysis of hospital Medicare margins is based on data in the Hospital Cost Report Information System (HCRIS) database. Medicare margins are calculated for the entire hospital, and for the component areas: inpatient, outpatient, direct medical education, rehabilitation and psychiatric units, skilled nursing units and home health agency.

Tools access statewide margins and margins by Congressional district. Hospital-specific reports may be requested by contacting Berna Bell, Health Policy Analyst.

Medicare Hospital Revenue Forecaster™

Through a partnership with the Healthcare Association of New York State, DataGen, Inc., OHA Is making available to members a subscription service to the Medicare Hospital Revenue Forecaster.™  The Forecaster is both a budgeting tool and an impact analysis tool that contains all of the components of the Medicare payment systems for inpatient, outpatient and post acute care.

For prospective payment system (PPS) hospitals, the Forecaster makes it easy to estimate the impact of the Final 2008 Inpatient PPS rule. Simply plug in the new update factors and wage index to learn the impact of these changes on the hospital's cost reporting year, using 2006 cost report data. This differs from traditional hospital association impact reports that are limited to the federal rate year and rely on slightly older data from the federal public use files. The Forecaster allows hospitals to see and change all assumptions about volumes, Medicaid percentages, teaching programs, etc.

For PPS hospitals, hospital claims-specific analyses are added to provide cost reporting year impacts of such changes including:

• the switch from charge-based DRG weights to cost-based/severity adjusted weights
• outpatient PPS case-mix changes and outlier reductions

For critical access hospitals, the latest version includes a new worksheet for evaluating interim payments compared to current year costs and volumes.

Subscribers also receive updates for significant legislative and regulatory changes.  In addition, training and support are available at all times.

For more information, please contact:

Kelly Price, Manager                                               Berna Bell, Director
Medicare Hospital Revenue Forecaster             Health Policy
DataGen, A HANYS Solutions Company            Ohio Hospital Association
(518) 431-7629                                                       (614) 221-7614