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By Ken Perez
The Budget Control Act of 2011, generally referred to as the debt deal, creates and tasks a 12-member Joint Committee of Congress (the so-called Super Committee or Super Congress) to produce proposed legislation by November 23, 2011 that would reduce the U.S. deficit by at least $1.5 trillion over 10 years. Each chamber of Congress would consider the proposal of the Joint Committee on an up-or-down basis without any amendments by December 23, 2011.
This is a sample article from HFMA's Payment & Reimbursement Forum, an online discussion community for healthcare reimbursement, managed care, and finance leaders.
Learn more and join the Payment & Reimbursement Forum
If the Joint Committee fails to agree on and produce a proposal with at least $1.2 trillion in spending cuts, the debt deal sets up a new sequestration process to cut spending across-the-board and ensure that any debt limit increase is met with greater spending cuts.
The across-the-board spending cuts would apply to FY13 through FY21, and apply to both mandatory and discretionary programs. Exempt from the cuts: Medicaid, welfare programs (e.g., food stamps), and other low-income subsidies, as well as Social Security, veterans' benefits, civilian and military retirement, and net interest payments.
However, the across-the-board cuts would apply to Medicare, though the cut to Medicare is capped at 2 percent, which would reportedly save $126 billion.How large a cut could the Joint Committee conceivably propose for Medicare? That's the $64 million, or in these times, perhaps the $64 billion question. Given all the "across-the-board" language, a proportional model could provide a good analytical starting point:
What would this mean on a per-hospital basis? The IPPS cuts would translate into a cut of $1.5 to $1.9 million for the average IPPS hospital (with an estimated 210 beds) per year, which would be equivalent to a 2.3 percent to 2.9 percent average annual reduction to the IPPS.
We need to remember that such debt deal-driven cuts would be in addition to health reform-mandated reductions to the IPPS, which total $112 billion for FY12 to FY19. So what would be the combined, cumulative impact? For the 10-year period of FY12 to FY21, payments to hospitals under the IPPS would be sliced by $162 to $177 billion. This would translate into a cut of approximately $5 million per hospital per year, relative to pre-health reform conditions.
Ken Perez is director of healthcare policy and senior vice president of marketing, MedeAnalytics, Emeryville, Calif., and a member of HFMA's Northern California chapter (email@example.com).
Forum members: Please add your insights, questions, and comments about this article via the Payment and Reimbursement Forum's LinkedIn discussion board.
Or perhaps you have another discussion starter?
Publication Date: Thursday, September 15, 2011
Tom Myers, chief strategy officer, The SSI Group, discusses the shifting payment environment and how it affects providers' patient access and claims management processes.
Jeff Chester, senior vice president and chief revenue officer at Availity, shares his thoughts on "Revenue Cycle 2.0" and how to best meet its challenges.
Mitch Morris, vice chair and global leader, healthcare, Deloitte, and Michael O'Rourke, senior vice president and chief information officer, Catholic Health Initiatives (CHI), share perspectives on the need for transformational IT in health care today.
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
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