Becker's Hospital Review

9 CFO / FINANCE Most big US hospitals are defying price disclosure rule By Ayla Ellison M ost of the largest U.S. hospitals are not in compliance with the CMS rule on hospital price transparency that went into effect Jan. 1, according to a March 16 blog post published in Health Affairs. The rule requires hospitals to make public "a machine-readable file containing a list of all standard charges for all items and ser- vices." To comply with the rule, hospitals' files must contain gross charges, discount cash prices, payer-specific negotiated charges, deidentified minimum and maximum charges, and descriptions of and codes for the services and items provided by hospitals. Sixty-five of the 100 largest U.S. hospitals, based on bed count, were not in compliance with the rule, according to price transpar- ency files collected from late January to early February. Twelve of the 65 noncompliant hospitals didn't post any files or provide links to searchable databases that were not downloadable. The rest of the noncompliant hospitals either did not include payer-specific negotiated rates with the name of the payer and plan clearly asso- ciated with the charges or were in some other way noncompliant. Of the remaining 35 hospitals, 22 appeared to be compliant with the rule based on the price transparency files, and some exceeded the regulation's requirements in terms of the amount of information they shared. There were some challenges to assessing compliance with the rule, including that it isn't always possible to compare a publicly posted standard charge file to a chargemaster to check that all of the elements of the file are contained in the chargemaster. n Hospital finances in 2021: 10 things to know By Ayla Ellison L ower patient volume, canceled elective procedures and higher expenses tied to the COVID-19 pandemic have created financial challenges for some hospitals, while others are seeing their finances begin to improve. Ten things to know about hospital finances: 1. e pandemic could cause U.S. hospitals to face between $53 billion and $122 billion in revenue loss this year, accord- ing to a study from healthcare consulting firm Kaufman Hall commissioned by the American Hospital Association. 2. Under a scenario in which there is complete recovery of patient volume, quick vaccine progress and a sustained de- cline of COVID-19 cases, hospitals could lose $53 billion in revenue. is would include a $27 billion loss in outpatient revenue, $17 billion in inpatient revenue and $9 billion in emergency department revenue. 3. Under a scenario in which there is a partial recovery of patient volumes, slow vaccine progress and cyclical COVID-19 surges, hospitals could lose $122 billion. is would include $64 billion in lost outpatient revenue, $41 billion in lost inpatient revenue and $17 billion in lost emergency department revenue. 4. Last year, hospitals experienced increases in certain ex- penses, including those related to drugs, supplies and labor, and those expense pressures could continue this year, ac- cording to the Kaufman Hall report. 5. Increased costs threaten the financial outlook for the hospital sector, and hospitals will face a challenging finan- cial environment this year, according to reports by Fitch Ratings and Moody's Investors Service. 6. Hospital operating margins fell nearly 27 percent be- tween December 2020 and January 2021, according to Kaufman Hall. 7. Many hospitals across the country took a financial hit from the COVID-19 pandemic, but some large health systems were still profitable in 2020. eir financial per- formance was fueled by several factors, including higher investment returns and higher-acuity patients. 8. Several for-profit and nonprofit systems that have re- leased their full-year 2020 results have reported net income of $1 billion or more. 9. A variety of issues have put rural hospitals in a fragile fi- nancial position. Last year, 20 hospitals in rural communities closed, making 2020 a record year for rural hospital closures. 10. Rural hospitals could be offered some relief under the $1.9 trillion COVID-19 package President Joe Biden signed March 11. It provides $8.5 billion for rural health- care providers. n New York hospital takes $34M hit from nearly 2,700 canceled surgeries By Ayla Ellison E rie County Medical Center in Buffalo, N.Y., is working to re- cover revenue lost due to canceled surgeries and lower pa- tient volume tied to the COVID-19 pandemic. The 573-bed hospital reported a 6 percent year-over-year de- cline in emergency department visits in 2020, leading to a reve- nue drop of $1.5 million, according to Buffalo Business First. Canceled elective surgeries took a bigger financial toll on the hospital. The suspension of elective procedures last year led to nearly 2,700 canceled surgeries and $34 million in lost revenue, according to the report. "It is a financial hit for us to have fewer visits, but the more severe financial hit was lack of surgeries; that is the heart financially of the organization," Erie County Medical Center President and CEO Thomas Quatroche Jr., PhD, told Buffalo Business First. n

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