Reimbursement: What Does the Future Look Like?

  January is an excellent time to take a step back and ponder our future. What issues will be challenging our leadership this year? What trends have surfaced that require our attention? We’ll start the conversation with reimbursement. Year after year, it tops the list as we continue to see revenue erosion and rising expenses. In most states, reimbursement alone is inadequate to keep pace with our increasing costs. In addition, Medicare seems to always be looking for ways to reduce our payments. Due to the Affordable Care Act, the number of people covered by Medicaid, typically a poor payer (i.e., low levels of reimbursement), has increased by an average of 10%. Medicare has reduced its rates twice in the last six years in many jurisdictions. Finally, the national sequester, which further reduced Medicare by 2%, remains in effect. Pressure to Reduce The continuing merger of major insurance companies has given the resulting giants more leverage to negotiate lower reimbursement rates against providers. The pressure to limit or reduce local, county and state taxes poses a further threat, as elected officials push for cutbacks to entitlements and reductions in the cost of public health and safety services. The new national trend to require non-profit hospitals to pay real estate taxes on programs not directly associated with their core missions has stretched budgets and is affecting the EMS services they provide. Medicare continues to look at new ways to reimburse providers...
Source: JEMS Administration and Leadership - Category: Emergency Medicine Authors: Tags: Columns Administration and Leadership Source Type: news