Children's Hospitals Today - Fall 2017 - 30

VITALS / NEWS AND UPDATES

Examining Medicaid underpayment
Pediatric-focused report reveals the disparity in reimbursements.

dult and pediatric hospitals caring for Medicaid patients
received payments of 90 cents for every dollar spent,
based on FY2015 survey data, according to the American
Hospital Association (AHA). AHA also reported 60 percent of
hospitals received Medicaid payments
at less than cost. But pediatric-only
Learn more
about the Annual
data from FY2016 in the Children's
Benchmark Report at
Hospital Annual Benchmark Report
childrenshospitals
.org/ABR.
(ABR) indicates children's hospitals
received payments ranging from

35 cents to 86 cents for every dollar spent (for more, see
"Disparity of reimbursement" below). And 92 percent of
children's hospitals received Medicaid payments at less than
cost, which includes disproportionate share (DSH) and tax appropriation payments. As legislators look for ways to reduce
spending, it's important to understand how Medicaid supplemental payments work. Without these payments, children's
hospitals' Medicaid underpayment would expand from 12
percent to 22 percent, directly affecting the services and care
children's hospitals provide.

A CLOSER LOOK

Disparity of
reimbursement

ADC >125 days
38 hospitals

ADC ≤ 125 days
11 hospitals

Specialty
16 hospitals

Here's a look, by average
daily census (ADC), at how
Medicaid underpayment
would expand without
supplemental payments for
acute and specialty hospitals.

With supplemental payments

Without supplemental payments
Source: 2017 Children's Hospital Annual Benchmark Report

PEDIATRIC QUALITY
AWARD SETS RECORD

The Pediatric Quality Award
(PQA) is about sharing
improvements across
children's hospitals. A
record 110 projects from 60
children's hospitals were
submitted when the 2017
call for entries closed in
July. That's an increase of 45
percent from the 2015 award
and an opportunity to spread
more practices making
a difference in children's
health care. Projects that
hospitals entered focused on:
* Changing clinical care
* Transforming care delivery

* Improving patient safety
* Achieving waste reduction
Hospital judges will select
semifinalists in October, and
three judges with industry
expertise will choose the
finalists in December.
Winners will be announced at
the 2018 Quality and Safety
Conference March 5-7. Learn
more at childrenshospitals
.org/qualityaward.

CARE AWARD: EARLY
RESULTS AVAILABLE

Now in its third year, the
CARE Award is a national,
CMMI-funded study aimed

CHILDREN'S HOSPITAL S TODAY Fall 2017

at improving outcomes and
reducing the cost of care
for children with complex
medical conditions enrolled
in Medicaid. Ten children's
hospitals partner with CHA
in this work, which aims to
inform sustainable change
in health care delivery. The
study includes more than
8,000 patients, as well as
their families and health care
payers. Final results will be
released in June 2018. Learn
about early outcomes of the
CARE Award, review white
papers and read case studies
from participating hospitals
at childrenshospitals.org/
careaward.

DIABETES CARE SAFETY
RESOURCES AVAILABLE
More children are being
diagnosed with diabetes, and
the ability to manage their
care remains a challenge as
the disease process can be
complex and lead to other
conditions. If symptoms of
diabetes complications are not
recognized early, the outcomes
can be life threatening. The
Child Health Patient Safety
Organization offers resources
to help hospitals mitigate
risk and provide the best
care for high-risk pediatric
populations. For more, visit
childrenshospitals.org/alerts.

http://childrenshospitals.org/ABR http://childrenshospitals.org/qualityaward http://childrenshospitals.org/qualityaward http://www.childrenshospitals.org/careward http://www.childrenshospitals.org/alerts http://www.childrenshospitals.org/careward

Table of Contents for the Digital Edition of Children's Hospitals Today - Fall 2017