Becker's Hospital Review

11 CFO / FINANCE CommonSpirit rebounds, posts $998M operating income By Ayla Ellison C ommonSpirit Health, a 140-hospital system based in Chicago, saw its oper- ating income rebound in the fiscal year ended June 30. CommonSpirit, formed in 2019 through the merger of San Francisco-based Dignity Health and Englewood, Colo.-based Catholic Health Initiatives, saw revenues rise 12.4 percent year over year in the most recent fiscal year. e in- crease was primarily attributed to recovering patient volume and new care sites. Expenses also increased because of pandem- ic-related costs. Expenses were up 7.1 percent year over year. CommonSpirit recorded operating income of $998 million in fiscal year 2021, compared to an operating loss of $550 million a year earlier. Federal relief provided through the Coronavirus Aid, Relief and Economic Secu- rity Act and a one-time sale of joint venture shares pushed the system's income higher in the most recent fiscal year. Without those funds, CommonSpirit posted an operating loss of $215 million. "ese results show that we are navigating the pandemic in a purpose-driven, financially responsible way that has allowed us to prior- itize providing essential care and supporting our clinicians and employees," CommonSpirit CFO Dan Morissette said in a news release. "Being financially sustainable means we can deliver on our mission of providing care to ev- eryone, especially those in need. As Common- Spirit enters its third full fiscal year, we are in a much better position to navigate health care's 'new normal' compared to prior years." CommonSpirit recorded $3.4 billion in invest- ment income in fiscal year 2021, and the system closed out the period with excess revenues over expenses of $5.2 billion. Between the beginning of the pandemic and September, CommonSpirit has seen more than 234,000 COVID-19 patients. e system said its COVID-19 patient census increased to 2,878 in early September, up from a low of 340 in June. n Texas hospital says coding problem caused $555K COVID-19 billing error By Katie Adams A coding error was the reason Midland (Texas) Memorial Hospital paid $555,141 to resolve improper claims allegations made by the HHS Office of Inspector General, hospital leaders told local television sta- tion KWES-TV Sept. 16. After noticing it had improperly submitted claims to the COVID-19 unin- sured program, the hospital said it self-disclosed the conduct to the office and agreed to pay the $555,141. The inspector general alleged that Midland Memorial presented reim- bursement claims for testing, treatment and vaccine administration to the program for services rendered to patients without a COVID-19 primary diagnosis, or pregnancy with COVID-19 as a secondary diagnosis. The al- leged misconduct would be a violation of the Civil Monetary Penalties Law. The hospital said it miscoded 87 uninsured patients who never had COVID-19, resulting in more reimbursement from the HHS Health Resources and Services Administration. The sequencing of coding is different for insured and uninsured COVID-19 patients, according to Midland Memorial CEO Russell Meyers. Samuel Moore, the CFO, agreed, saying "the way that HRSA wanted us to code COVID-positive self-paid patients was different than what we would've done for anyone else." The coding team typically list another condition before COVID-19, but the resources and services administration requires them to list COVID-19 first. Hospital leaders said this caused the coding to get misrecorded. The hospital asked its third-party billing auditor to review all of its COVID-19 claims a few months after it discovered the error. Hospital leaders said in September that the review process continues. n Physician 'gold card' law to reduce prior authorization delays in Texas By Katie Adams A new Texas law took effect in September seeking to cut prior authori- zation delays by rewarding physicians with high prior authorization approval rates, according to the American Medical Association. Under the law, physicians who have a 90 percent prior authorization ap- proval rate over a six-month period on certain services are exempt from prior authorization requirements for those services. Their exemption is referred to as their "gold card." Since physicians with gold-card status consistently meet prior authorization requirements for cer- tain services, state-regulated insurers won't delay care for those services. Gold carding is a prior authorization reform supported by numerous medical associations, including the American Medical Association, American Hospital Association, American Pharmacists Association and American Academy of Family Physicians. n

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