Inpatient and Outpatient Hospital Reimbursement Redesign

B&A developed new payment methodologies for inpatient and outpatient hospital services. The previous methodologies had not been substantially updated for 15 years. Activities included developing multiple impacts for hospital CFOs as methodologies developed, facilitating hospital CFO and billing staff meetings on implementation, technical assistance to EDS on pricing algorithms, changes to the state plan and communications with CMS. The inpatient system (DRG) was implemented 1/1/08. The outpatient system (based on Medicare OPPS) was implemented 5/1/08. OVHA recently extended B&A’s contract for an additional year to assist in ongoing maintenance and monitoring.

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