To increase reimbursement for low historic relative price hospitals
Impact
If enacted, this measure would amend Chapter 6D of the General Laws to set specific benchmarks for reimbursement rates starting from 2026. During the initial cycle from 2026 to 2029, no in-network low historic relative price hospital could receive payments less than 15% below the average relative price of other acute hospitals in their carrier's network. This aims to enhance their reimbursement structure compared to more affluent facilities, ensuring that they receive fair compensation for their services.
Summary
House Bill 1387, titled 'An Act to increase reimbursement for low historic relative price hospitals', aims to adjust the reimbursement rates for acute hospitals that are categorized as low historic relative price hospitals. Defined by an average statewide relative price of less than 0.90 over a five-year period, these hospitals are either independent or affiliated but negotiate contracts on their behalf. The bill proposes to not only list such hospitals annually but also establish equitable reimbursement targets to support their financial viability.
Contention
The proposed reimbursement plan includes further increases in subsequent cycles, ensuring that these low-price hospitals receive annual rate hikes that exceed the general healthcare cost growth benchmarks over the following years. This ensures sustained financial support and adaptability in their operations. Some stakeholders may raise concerns regarding the funding sources for these adjustments and the potential impact on overall healthcare costs across the state.