GESUNDHEIT HOSPITAL 2020 HOW TO
We focused our analysis on hospitals with the highest and lowest shares of revenue from private payers to inform policy decisions regarding how to allocate any remaining grants to providers as well as any potential new funding from Congress. Hospitals typically command rates from private insurers that average twice Medicare rates per patient, and some are paid substantially higher rates from private insurers in highly concentrated markets. Reimbursement rates vary widely by payer. Hospital revenue is mainly a factor of volume and payment rates per service or patient diagnosis.
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The brief focuses specifically on hospitals using data that hospitals report to the Centers for Medicare & Medicaid Services as part of the Healthcare Cost Report Information System (HCRIS). This brief examines the implications of the decision to allocate funding based on total net patient revenue, which is total patient revenue minus contractual allowances and discounts. The largest share of that $72.4 billion is the $50 billion that the Department of Health and Human Services allocated to providers who participate in Medicare based on their total net patient revenue from all sources. Congress stated the money can be used either for costs related to treating COVID patients or to reimburse for lost revenue due to the pandemic.
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This relief fund is designed to provide an influx of money to hospitals and other health care entities to help them respond to the coronavirus pandemic.
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The Department of Health and Human Services (HHS) has now begun distributing $72.4 billion of the $175 billion allocated for grants to health care providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.