OHA- HCAP

OHA Board-Approved HCAP Principles

Preamble:

Uncompensated health care services are not free health care services. Health care services are both social and economic goods where the cost of providing services, if not paid for by the individual receiving the services or their third-party payer, must be met by some other entity. The hospital community has assumed the responsibility for ensuring access to health care services for the vast majority of America’s uninsured population. However, this burden can no longer be borne by charitable contributions, local government subsidies, profits from the care of those with insurance, and special payments to hospitals made available through the Medicare and Medicaid programs. This burden is a threat to the financial viability of Ohio’s hospitals and business community.

Purpose:

The purpose of the Hospital Care Assurance Program (HCAP) is to make special payments to Ohio hospitals to underwrite a portion of the unpaid costs of providing health care services to Ohio’s Medicaid population and individuals without health insurance coverage.

The Four Principles of HCAP:

Distribute all available federal disproportionate share hospital dollars through a formula that is equitable and fair, stable, predictable, timely, simple, de-politicized, and in accordance with state and federal law and Board-approved indexes.
Address the unique economic needs of hospitals that serve a disproportionate share of Medicaid and uninsured patients.
Minimize hospital losses from the impact of any assessment.
Reimburse uncompensated care provided to individuals who are uninsured or covered by the Medicaid program.

The HCAP Advocacy Agenda of the OHA:

HCAP is not sufficiently funded to fully reimburse hospitals for all of the costs of providing uncompensated care. Until such time that the program is fully funded, the main goal of the association’s advocacy efforts related to HCAP will be to increase the federal funding of HCAP. Additionally:

HCAP is not a substitute for a well-funded Medicaid program with adequate reimbursement for inpatient and outpatient hospital services. The OHA will continue to advocate for payment increases in Medicaid.
Fund the state share of HCAP with a broad-based, statewide funding source. The OHA will advocate for a substitute for hospital assessments, provided that Ohio hospitals would retain both the state and federal funds generated by HCAP.
Repeal the federal laws that prohibit hold harmless provisions on provider assessments.