Hospital finance impacted by hidden provisions of Senate health reform bill

In a clear case of what-you-don't-know-could-affect-your-bottom-line, the Senate's version of the healthcare reform bill contains little-known provisions that directly relate to hospital finance. True to congressional tradition, favorite causes have found their way into the 2,000-plus pages of the "Patient Protection and Affordable Care Act," reports Kaiser Health News.

At the urging of two senators--Blanche Lincoln (D-Ark.) and Olympia Snow (R-Me.)--the bill calls for increased Medicare payments for dual energy X-ray absorptiometry (DXA) or bone density scans. Since 2006, lawmakers have reduced payments for some imaging services, including bone density scans, in an effort to control costs. This new provision would restore payments to 70 percent of 2006 levels--not a complete return to past levels, but an improvement.

The second provision would call on nonprofit hospitals to close the gap between how much they charge insured patients and self-pay patients for emergency room services. In 2007, the journal Health Affairs published a study that showed that hospitals often charge uninsured and self-pay patients more than three times Medicare-allowable rates and 2.5 times as much as insurance company reimbursement rates. 

The Senate bill would limit ER charges for self-pay patients to the lowest amount received from insured patients for the same services. The bill also would require all hospitals to put in place financial aid and discount programs. Some hospitals already have such programs.

For more info:
- read this Kaiser Health News report

Suggested Articles

Humana has added additional providers to its orthopedic bundled payment models, the company announced. 

States that spend more on primary care have better outcomes, including fewer hospitalizations and emergency department visits, says a new study.

Technology company Philips has acquired Boston-based startup Medumo, the developer of patient navigation and engagement solutions.