News Briefs

Uncompensated care at $24.9 billion in 2003

U.S. hospitals provided $24.9 billion in uncompensated care in 2003, up from $22.3 billion in 2002, according to the latest American Hospital Association (AHA) Annual Survey of Hospitals. The survey measure includes charity care and bad debt, valued at the cost to the hospital of the services provided. The amount of uncompensated care provided by hospitals has increased by $3.3 billion, or more than 13%, since 2000.

AHA president Dick Davidson said America’s community hospitals always have found ways to help patients who can’t pay their hospital bills because of limited financial resources and a lack of health insurance. But he said the major challenge facing America’s health system is that 45 million people are uninsured. The information on hospital uncompensated care comes from the AHA’s Annual Survey Data, 1980-2003.

NUBC seeks comment on billing data revisions

The National Uniform Billing Committee (NUBC), which maintains the billing data set for institutional health care providers, is seeking comment from hospitals and others on proposed revisions to the form and data set used to process health care claims. The changes are intended to better align the form and data set with the Health Insurance Portability and Accountability Act’s transaction standard and other national standards. The NUBC will accept comments through Feb. 1, 2005, and plan to review comments at its Feb. 22-23 meeting in Baltimore. A summary of changes to the billing form and data set, and a survey for submitting comments, are available at www.nubc.org/UB04.pdf.

Senior health care costs affecting public funding

A recent report by the Centers for Medicare & Medicaid Services’ Office of the Actuary concludes that higher relative health care spending by seniors, and their faster population growth will increase pressure on public funding of health care over the next several decades. People 65 and older made up 13% of the U.S. population in 1999, yet they consumed 36% of the nation’s spending for health care of $387 billion, or an average $11,089 per senior, the report notes. As the elderly share of the population increases to a projected 21.3% by 2049, the study estimates personal health spending could grow by an average 0.5% per year, increasing pressure on public funding of health care. About half of the average $11,089 spent on health care for seniors in 1999 was paid for by Medicare, and about 15% by Medicaid, the study notes.

To read the report, Age Estimates in the National Health Accounts, go to www.cms.hhs.gov/review/default.asp.

CMS: Discounts for uninsured patients OK

The Centers for Medicare & Medicaid Services issued much-anticipated additional guidance confirming that hospitals can offer discounts to any uninsured patients without putting the hospital’s Medicare payments at risk. The agency issued its first set of guidance in February, and responses from administration officials during a June open-door forum led hospitals to believe that offering discounts to any uninsured patient would be permitted and would not imperil Medicare payments.

However, the issue was reopened last fall. The new guidance, released as an FAQ (www.cms.hhs.gov/providers/FAQ_Uninsured_Additional.pdf), appears to confirm the information provided to hospitals last June that "individualized determinations of need" are not required to offer discounts to uninsured patients.

CMS survey to assess satisfaction with FIs

The Centers for Medicare & Medicaid Services (CMS) is developing a new survey to assess providers’ satisfaction with the services provided by fiscal intermediaries and other Medicare fee-for-service contractors. A draft survey is being sent to roughly 7,400 Medicare providers, including hospitals, in multiple states. The 76-question survey, which CMS estimates will take 22 minutes to complete, asks providers to rate contractors on administrative functions such as provider inquiries, claims processing, appeals, medical review, reimbursement and other areas.

The findings will be used to fine-tune the survey instrument before a planned rollout to all Medicare contractors in 2006. CMS plans to use the final survey instrument to help contractors improve the quality of their services, and create a performance-measurement standard for contracting purposes.

More information is available at www.cms.hhs.gov/providers.