The rates hospitals can charge for care would remain flat for the first six months of 2014 amid uncertainty over hospitals’ financial stability and proposed changes in how they are compensated, under a draft recommendation made by a state panel Wednesday.
Maryland’s hospital rate-setting agency typically sets the terms for hospitals’ reimbursement on an annual basis, but took a more tentative approach because of the upheaval.
Earlier this year, most state hospitals were given a 1.65 percent increase in rates for the first half of fiscal year 2014, which began in July, and the Health Services Cost Review Commission is suggesting that rates remain the same for the second half.
Representatives for hospitals and insurers agreed with the proposal at a public meeting, though the Maryland Hospital Association urged caution, saying the increase in rates has not translated into a surge in profits for hospitals.
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“We haven’t seen an immediate turnaround in hospital financial stability this early in the year,” Mike Robbins, the association’s senior vice president for financial policy and advocacy, told the commission.
He asked the commission to closely monitor hospital finances in the months ahead.
Representatives for CareFirst BlueCross BlueShield and United Healthcare endorsed the recommendation.
The commission’s proposal comes as the state’s health care industry awaits word on an application to the federal Centers for Medicare and Medicaid Services to overhaul how hospitals are paid. Instead of a fee-for-service model in which hospitals have an incentive to see more patients to make more money, state health officials have proposed switching to a model in which hospitals’ overall revenue is tied to state population growth. Hospitals would be given incentives to see fewer patients and send more of them to doctors’ offices and community health clinics when appropriate.
The commission is to take a final vote on the rate proposal at its Dec. 4 meeting, when it also could begin considering recommendations on incentives aimed at patient volume, said Steve Ports, deputy director for policy and operations for the commission.