The American Hospital Association sent U.S. representatives and senators a letter highlighting its priorities and concerns as Congress works on end-of-the-year priorities and fiscal challenges facing the nation.
AHA concerns involve proposals to reduce payments for evaluation and management services provided in hospital outpatient departments, and reductions under consideration by the Medicare Payment Advisory Commission that would broaden this concept to additional, as yet unspecified services.
Other concerns include proposals for additional across-the-board cuts to Medicare inpatient hospital rates through the use of retrospective coding adjustments for fiscal year 2010; for reductions in payments to hospitals for assistance to low-income Medicare beneficiaries (bad debt); and for reductions to Medicaid assessments.
The letter also advocates for the extension of critical Medicare provisions for small or rural hospitals, and urges Congress to ensure that Medicare is included in any delay of the Budget Control Act sequester.
Congress and the White House are attempting to negotiate a compromise to avoid the “fiscal cliff,” a combination of tax hikes and spending reductions set to take effect at the end of the year. Among the spending cuts is the Medicare “sequester,” a 2% reduction in payments to providers.
A 2011 report by Tripp Umbach, a firm specializing in economic impact studies, cited a potential loss of 194,000 nursing and other hospital jobs because of a 2% payment reduction. The report was commissioned by the AHA and American Nurses Association.
Any compromise plan, the parameters of which would have to be agreed on by the end of this month, still could affect provider payments in Medicare and possibly Medicaid.
“Hospitals ability to maintain the kind of access to care their patients and communities expect is threatened by repeated ratcheting of payments for Medicare and Medicaid hospital services,” the AHA wrote in the letter, which was signed by Executive Vice President Rick Pollack. “Additional cuts to Medicare and Medicaid funding for hospital services would mean longer wait times for care; fewer doctors, nurses and other caregivers; and less patient access to the latest treatments and technology.”