Every year, experts in the field make predictions about the health care industry. This year, there are five important things that might happen. According to Rick Pollack, president and CEO of the American Hospital Association, and Tom Nickels, the AHA’s executive vice president of government relations and public policy, CFOs, leaders, boards, and people in charge of hospitals and clinics need to keep an eye out for the following things.
1. Medicaid Disproportionate Share Hospital payments will be a key legislative issue. In December, lawmakers approved a year-end spending deal that delays $4 billion in cuts to Medicaid DSH payments until late May. Mr. Pollack said he believes Congress will address the issue longer term and repeal the cuts altogether this year.
2. Lawmakers will continue to discuss surprise billing. Progress on legislation to address surprise medical bills occurred in December after key lawmakers announced a bipartisan agreement. However, surprise billing legislation was not included in a $1.37 trillion spending agreement reached by congressional negotiators Dec. 16. The issue will be front and center as lawmakers discuss legislation in 2020, predicted Mr. Pollack.
3. Healthcare litigation will garner attention from courts and the public.Various litigation is pending in U.S. courts, including a Republican-led lawsuit over the constitutionality of the ACA. The Fifth Circuit Court of Appeals ruled in December that the ACA’s individual mandate to buy health insurance is unconstitutional, but left it to the lower court to decide whether that invalidates the entire law. Mr. Pollack said he believes this pending lawsuit, as well as a lawsuit challenging a federal rule that requires hospitals to disclose the rates they negotiate with insurers, will continue to garner attention from the public and courts this year.
4. “Medicare for All” will receive political attention.As presidential candidates continue to debate single-payer healthcare, Mr. Nickels said he believes “Medicare for All” will continue to receive political attention. He predicted the debate this year will be about what could happen legislatively on the issue after the 2020 election.
5. Healthcare consolidation will continue. Mr. Pollack predicted that consolidation in healthcare will continue due to the industry’s shift from fee-for-service to value-based payment. “From a hospital perspective, we will see that because as [healthcare] move[s] toward value-based payment, [hospitals] need to have scale to be able to take the risk that’s necessary under value-based payment mechanisms,” he said.
What You Can Do
Whether you believe these predictions or not, there is one thing that you can do now. If your hospital chain or series of clinics have unpaid aged claims that have gone through the state-level appeals process, you don’t have to leave them in your debt bucket. Instead, contact us. We specialize in collecting aged claims through the Federal ERISA appeals process. Reach out to us today.