Academic journal article Journal of Healthcare Management

PRACTITIONER APPLICATION: Measuring Nonprofit Hospitals' Provision of Charity Care Using IRS and CMS Data

Academic journal article Journal of Healthcare Management

PRACTITIONER APPLICATION: Measuring Nonprofit Hospitals' Provision of Charity Care Using IRS and CMS Data

Article excerpt

"Not everything that can be counted counts, and not everything that counts can be counted." Attributed to Albert Einstein

Hospitals and health systems in this century are the proud owners of enhanced analytics. Theoretically, the data will direct us to insights and tools to learn more about our business; provide direction for our next endeavors; advise us in shrinking or growing services lines; and enable us to report our quality, finance, and growth factors to external agencies. In reality, we must remember and understand that these data can be imperfect and bidirectional. Applying them to revenue cycle reporting can present challenges.

Gaskin, Herring, Zare, and Anderson have found challenges in charity care reporting to different governmental agencies. These issues can lead to significant consequences not only regarding accuracy, but also for determining the amount that hospitals receive from the Medicare Disproportionate Share adjustment and the Medicare Electronic Health Record (meaningful use payments). Disproportionate share payments are lifelines to many of the more than 3,000 hospitals participating in the federal programs that provide partial compensation for charity care. The authors illustrate this problem with many examples. Assuming no ill intent, we are still left wondering: How do these differences in reporting happen? Furthermore, because they can be repeated in various health systems and populations served, the discrepancies must be addressed at both system and government levels, as there are substantial implications for future allotments. …

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