Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit - 2025 coming soon
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Government
May 10, 2018 12:00 AM

Senators to Azar: Why aren't you fixing Medicare wage index?

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images
    Sen. Lamar Alexander (R-Tenn.)

    Senators on Thursday asked HHS Secretary Alex Azar on Thursday why the CMS' newly unveiled rural health strategy does not address the Medicare wage index, which they claim poses one of the greatest threats to access to care in these areas.

    Under the index, payments to hospitals are adjusted for market conditions such as the differences in hospital wage rates among labor markets and it also takes into account cost of living.

    As things are now, a hospital in Tennessee could bill CMS for $100 and get $82 from Medicare, while a hospital in Connecticut could get $126 for the same claim, Sen. Lamar Alexander (R-Tenn.) said during a Senate Appropriations subcommittee hearing on HHS' fiscal year 2019 budget proposal.

    "There is a big fairness issue because of the wage index," Alexander said. "CMS announced a rural health initiative, but it didn't include any relief from the wage index."

    Hospitals and physicians with higher average wages, which also tend to be in higher cost areas, get larger reimbursements, and regions with lower wages are reimbursed at lower rates.

    Alexander called the wage index discriminatory and said it's leading to some hospitals to close.

    Sen. Jerry Moran (R-Kan.) claimed the wage index leads to a shortage of some provider types in rural areas.

    "What happens is if you're a cardiologist you have a tendency to move to the East Coast where you can get paid more for the same procedure," Moran said.

    Azar called the wage index one of the most vexing issues facing his agency because its structured to be budget neutral. As a result, the agency couldn't change the way rates are paid in one state without it impacting another state he said in response to Alexander's question.

    "It leads to a constant back and forth of winners and losers," Azar said. Without congressional action, the agency can do little to tinker with the index, he said.

    It's unclear if lawmakers across the aisle would support a change to the index. Sen. Chris Murphy (D-Conn.) said the current system makes sense as not only are costs higher in states like his, but they also pay higher taxes than more rural markets.

    "If we're interested in equity and parity than we would be more than happy to adjust tax rates," Murphy said. "If that was the deal, we'd be more than happy to accept less in Medicare reimbursement."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    GettyImages-654573744.jpg
    Federal watchdog to retract medical debt collection opinion
    HHS AGENCY
    HHS launches DEI investigation into California medical school
    Most Popular
    1
    How one Blue Cross CEO aims to solve Medicare Advantage
    2
    26 hospitals band together on a clinically integrated network
    3
    Medicare, exchanges highlight Centene's first quarter
    4
    After Thompson killing, health insurers poured money into security
    5
    Epic CEO Judy Faulkner on AI, antitrust and consolidation
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit - 2025 coming soon
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content