Washington hospital commercial payment among lowest in country, compared to Medicare payment – Washington State Hospital Association

A current evaluation of hospital claims knowledge by the RAND Company decided that business fee charges for Washington hospitals are among the many lowest within the nation, when in comparison with Medicare fee for a similar providers. In accordance with the evaluation, the mixture differential for Washington hospitals was the third lowest among the many 49 states and District of Columbia. For Washington hospitals, common business fee was lower than 175 p.c of Medicare fee in comparison with the nationwide common of 224 p.c. As well as, well being techniques that embrace Washington hospitals had been typically within the decrease finish of the vary of business fee charges as a proportion of their Medicare fee charges in comparison with well being techniques nationally.

The comparatively low fee for Washington hospitals is noteworthy given the huge underpayments they expertise below the Medicare and Medicaid applications. To stay financially viable, hospitals should have the ability to subsidize their losses on Medicare and Medicaid although different revenues, together with business fee. Whereas Washington State has dramatically expanded its Medicaid program to now embrace greater than 1.8 million enrollees, Medicaid hospital fee charges haven’t had a normal improve in additional than 20 years and the fee charges don’t replicate will increase to wages, rising drug prices, or different elements influencing the price of care.  Presently, Medicaid pays about 65 p.c of the particular value of offering hospital care to Medicaid enrollees, leading to an combination lack of greater than $1.4 billion per yr.

Whereas WSHA appreciates the work completed to higher perceive variations in business fee amongst hospitals, we encourage extra examine and consideration of the influence of Medicaid underpayments and price inputs equivalent to labor and medicines on the general value of offering care.