Issue link: https://beckershealthcare.uberflip.com/i/821337
26 CFO / FINANCE Study: Hospitals in Medicaid Expansion States Saw Average Revenue Increase of $5M Through 2015 By Tamara Rosin W ith the ACA still intact — for now — the 19 states that have not expanded Medic- aid under the law have the option to do so, a decision with important implications for hos- pitals, according to a report from the Robert Wood Johnson Foundation and the Urban Institute. Expanding Medicaid could decrease hospitals' un- compensated care attributed to providing care to uninsured patients while increasing revenue from new Medicaid enrollees. e RWJF and Urban Institute study estimates the effects of Medicaid expansion on hospital finances through 2015 and how they compare between hospitals in states that expanded the program and those that did not. Here are five main findings from the report. 1. As of 2015, Medicaid expansion was associated with a $3.2 million decline in average uncompensat- ed care costs and a 1.7 percentage point reduction in average uncompensated care costs as a percentage of total expenses per hospital. 2. e $3.2 million decline in uncompensated care costs represents a 34 percent decrease from hospi- tal's overall uncompensated care from 2011 to 2013. 3. Medicaid expansion was also associated with a $5 million annual increase in average Medicaid reve- nue per hospital. is comes out to a 2.9 percentage point increase in Medicaid revenue as a percentage of total revenue. 4. e $5 million increase represents an 18.1 percent increase in Medicaid revenue when compared with the baseline average of $27.9 million among hospi- tals in expansion states. 5. Hospitals in expansion states also improved op- erating margins by 2.5 percentage points and excess margins by 1.7 percentage points, increases that represent 67.3 percent and 41.4 percent increases in operating excess margins, respectively, compared to baseline means in expansion states. n Seema Verma Won't Weigh in on Kentucky Medicaid Decision Due to Conflict of Interest By Kelly Gooch C MS Administrator Seema Verma will recuse herself from an agency decision on whether Kentucky can add a work requirement to its Medicaid expansion, reports Kaiser Health News. Here are three things to know. 1. Kentucky expanded Medicaid under the ACA in 2014 and is proposing changes to the program. As part of the changes, nondisabled Medicaid ben- eficiaries could only receive health coverage if they work or do community service, according to the report. Kentucky also seeks to require Medicaid beneficiaries to pay monthly premiums of $1 to $37.50, the report states. 2. Kentucky seeks a waiver from CMS for its Medicaid expansion plan. However, Ms. Verma said she will recuse herself from the decision due to conflict of interest, according to the report. This conflict of interest stems from the fact she assisted in drafting the state's Medicaid reform plan in 2016 via her health consulting business, the report states. 3. CMS is expected to approve Kentucky's waiver with a work requirement in some shape or form, according to the report. n CMS Finalizes 2018 Medicare Advantage, Part D Rates: 4 Things to Know By Morgan Haefner C MS finalized a 0.45 percent rate increase for the Medicare Advan- tage and Part D programs in 2018. Here are four things to know. 1. The rate finalized Monday in CMS' 2018 Rate Announcement and Call Letter is up from the 0.25 percent proposed in February. 2. The agency predicts Medicare Advantage plans and Part D sponsors will see a 2.95 percent change in revenue in 2018, after accounting for trends in coding acuity. 3. CMS finalized polices that encourage safeguards for opioid dispensa- tion at pharmacies. In a press release, the agency said it "expects all Part D sponsors to focus on improving the coordination of care among enrollees using high dos- age of opioids, and in particular, Medicare Advantage plans that include prescription drug coverage should consider expanding the care manage- ment they provide enrollees." 4. CMS also issued a Request for Information for feedback on Medicare Advantage and Part D programs. n