President’s Message

Seeking Payment and Policy Reform

As 2022 draws to a close, the pandemic’s backlash continues, and our hospitals face a daunting financial crisis. Hospital staff are leaving the field in massive numbers due to burnout, causing hospitals to employ high-cost contract labor and their staffing budgets to skyrocket. Material and supply costs are up, the cost of medication is up, inflation affects every part of hospital operations. For months, we’ve been sounding the alarm that payment reform and other financial help for our hospitals is needed.

Limited reform has been enacted, but much more is needed. At the federal level, the Centers for Medicare & Medicaid Services (CMS), after engagement with the American Hospital Association, raised both Medicare inpatient and outpatient payment rates. Importantly, it has agreed to use more recent data in its future calculations, which should more accurately reflect the effects of inflation and rising costs hospitals are experiencing today.

We await a Senate vote on prior authorizations (HR 3173), which have become an administrative nightmare for hospitals. CMS’s proposed rule would remove inappropriate barriers to patient care by streamlining the prior authorization process for some health insurance plans, including commercial insurers and Medicare Advantage plans. This should reduce dangerous delays in care for patients and, at the same time, reduce unnecessary costs to the health care system.

Here is where advocacy – and your voice – make a difference. As the 2023 Legislative Session and the 118th Congress approach, we’ll be asking you to get in touch with your elected officials at both the state and national levels. You can support your local hospital and the hospitals of Arkansas by telling your elected officials how proposed legislation will directly affect your community hospital. You’ll be giving the message they need to hear: Their action has a direct impact on your community hospital’s viability.

At the state level, we’ll be conducting Advocacy Days at the Capitol, where you can deliver hospitalspecific information in person. (See page 11.) This year, we’re watching for possible changes to the Medicaid program, particularly after a rate review is completed and results are published. We’re working for new ways to maximize supplementary payments by addressing Upper Payment Limits. We will also support legislation that addresses concerns with prior authorizations at the state level currently required by commercial insurance plans.

Our hospitals find ways – somehow – to continue forward through surge after surge of COVID, and they’re bursting at the seams today not only with COVID patients but also with those who have contracted RSV or influenza. So far, Arkansas hospitals are keeping their doors open despite extreme challenges resulting from a perfect storm caused by the pandemic, supply chain disruptions, inflation, staffing shortages, and rising costs.

Our hope for 2023 is that we will see a turnaround in our hospitals’ financial challenges. We’ll continue to advocate – and ask you to add your voice – as policy makers seek ways to ease hospitals’ acute financial burden.

Bo Ryall

President and CEO Arkansas Hospital Association