Facts miss­ing

Modern Healthcare - - OPINIONS LETTERS -

Mod­ern Health­care’s story about some states’ ef­forts to change the ‘ru­ral floor’ sec­tion of the area wage in­dex back to state bud­get neu­tral­ity (“Tack­ling the wage in­dex,” Feb. 27, p. 14) was miss­ing a few key facts.

The story’s po­si­tion that statewide bud­get neu­tral­ity for wage-in­dex ad­just­ments was the sta­tus quo “un­til the Pa­tient Pro­tec­tion and Af­ford­able Care Act” was in­cor­rect. Na­tional bud­get neu­tral­ity was the law for all wage-in­dex ad­just­ments un­til 2009, when the CMS sin­gled out the ru­ral floor ad­just­ment for change. All other bud­get neu­tral­ity pro­vi­sions in the en­tire Medi­care pro­gram, in­clud­ing all wage-in­dex ad­just­ments other than the ru­ral floor, were ap­plied—and still ap­ply—on a na­tional level. Also im­por­tant to note is that nine of the hospi­tal as­so­ci­a­tions now protest­ing the cor­rec­tive ac­tion were among the 27 state hospi­tal as­so­ci­a­tions that op­posed the CMS’ un­prece­dented ac­tion at that time.

There is noth­ing in the ACA that calls for treat­ing Mas­sachusetts dif­fer­ently from any other state. The ACA pro­vi­sion sim­ply re­stores the pol­icy that was in place un­til 2009. What the statute does call for is a com­pre­hen­sive ex­am­i­na­tion of the en­tire area-wage sys­tem, which all of us can agree is com­plex and ar­cane. Any changes that are made should be based on this com­pre­hen­sive re­view.

Lynn Ni­cholas Pres­i­dent and CEO Mas­sachusetts Hospi­tal As­so­ci­a­tion



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