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Economic Sustainability  


OHA dedicates resources and programs to ensure the ongoing economic sustainability of hospitals and health systems throughout Ohio. Led by a team of professionals, OHA works with its members, partners and various state and federal agencies to help ensure a sustainabile economic envrionment for Ohio hospitals.

View October 10, 2013 Annual OHA Medicare/Medicaid Summit Materials

PowerPoint Slidedeck from Larry Goldberg and Larry Oday
HCAP/Ohio Hospital Franchise Fee/Medicaid Reimbursement Slidedeck from Ryan Biles
Sept. 17 Medicaid DSH Audit Slidedeck from Myers & Stauffer
CMS Medicaid DSH Audit Protocols
UPDATED Ohio Department of Medicaid DSH Audit Logs

Health Insurance Marketplace

Beginning October 1, 2013, the federal government launched healthcare.gov, which is also known as the health insurance exchange or marketplace.  In Ohio, the exchange is federally facilitated, but the state retains certain authorities to manage and oversee the insurers offering plans on the exchange.

Medicaid 

Medicaid is a state and federally funded program that guarantees health care coverage to eligible low-income and medically vulnerable people including: Children (up to 19), pregnant women, parents of children under 18, non-workers with disabilities, Ohioans aged 65 or older, and adults with family income less than 138% of federal poverty.

Medicare

Medicare is federal health insurance for people age 65 or older, under 65 with certain disabilities and any age with End Stage Renal Disease (permanent kidney failure) requiring dialysis or a kidney transplant. 


Franchise Fee

The Hospital Franchise Fee is a provider tax program that helps fund supplemental Medicaid payments for hospital services and provides additional resources to the state's Medicaid program in order to help ensure the program's payment adequacy and sustainability.

Hospital Care Assurance Progam

The Hospital Care Assurance Program (or HCAP) is the state's Medicaid disproportionate share (or DSH) program.  Funded entirely by hospitals, the program helps offset the uncompensated care of hospitals that serve a disproportionate number of uninsured patients and patients enrolled in Medicaid.

RAC Program

Recovery Audit Contractor (RAC) programs target Medicare and Medicaid payments CMS deems inappropriate and return under and overpayments to the federal government and health care providers.


Finance News
The latest news and updates on federal and state hospital and health system reimbursement policies and procedures.


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