The nation's hospitals could see $155 billion less in Medicare reimbursement, in part because of a new reimbursement structure, and $50 billion less in federal disproportionate-share hospital dollars under a deal struck by a trio of hospital associations and OK'd by key members of the Senate and the White House.
All told, about $103 billion would come from a reduction in marketbasket updates and productivity adjustments over the next 10 years, according to a source who requested anonymity. In return, the deal would ensure that any public health plan option would pay more like a private payer rather than a government program. Additionally, the deal would also ban physician referrals to clinics or hospitals in which they have an ownership stake. Reductions to the so-called DSH payments would begin in 2015 and would be contingent on whether or not certain coverage goals are first met.
The deal, expected to be announced on Wednesday, was struck between Senate Finance Committee Chairman Max Baucus (D-Mont.), the White House and representatives from the American Hospital Association, the Federation of American Hospitals and the Catholic Health Association.
The move marks a major achievement by Baucus to secure a sizable chunk of money that could be used to offset the roughly $1 trillion price of legislation meant to reshape the U.S. healthcare system.
Other measures include one that would shield hospitals for a decade from decisions made by an expanded Medicare Payment Advisory Commission—now being discussed by Congress—and another that would lighten a provision that would cut payments for patient readmissions.
The deal is also expected to include an agreement on hospital charity care, but those details have yet to emerge.
“I've been very impressed by how groups are coming forward and helping share responsibility,” Senate Budget Chairman Kent Conrad said late Monday, declining to comment on specifics of the hospital deal. “By and large, people are stepping up.”
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