Uncompensated Care Analytics

In 2015, Healthcare Payment Specialists (HPS) launched its Uncompensated Care Analytics (UCA) product. This solution was created with the anticipation that Worksheet S-10 would become an important component of the DSH formula, given the signals sent by the Centers for Medicare and Medicaid Services (CMS) that it was going to make this happen.

These signals culminated in a revision to the uncompensated care payment formula that was included in the FY 2017 Hospital Inpatient PPS Proposed Rule. This formula incorporated Worksheet S-10 as a component beginning in FY 2018. While the final version of the rule did not include the revised formula, CMS clearly intends to include Worksheet S-10 in the uncompensated care payment formula. As they stated: “We expect data from the revised Worksheet S-10 to be available to use in the calculation of Factor 3 in the near future, and no later than FY 2021.”

What This Means for Hospitals

While CMS has delayed implementation of Worksheet S-10 in the uncompensated care payment formula, the inclusion of Worksheet S-10 in the proposed rule and the clear language in the final rule regarding its future implementation, show that Worksheet S-10 will inevitably become a key component to that formula in the near future.

The uncompensated care payment formula in the 2017 proposed rule highlights CMS’s intent to use Worksheet S-10’s from prior fiscal years in the initial implementation. As shown in the table below, in the proposed rule, FY 2014 would have been the initial reporting period incorporated in the formula.

While the date for implementing Worksheet S-10 may be unknown, it is clear that hospitals need to ensure the accuracy and completeness of prior cost reporting periods as well as future ones.

HPS Solution

With deep expertise in complex and data-intensive cost report issues, such as Medicare Bad Debt and Medicare DSH, HPS is ideally positioned to work with hospitals to deliver Worksheet S-10s that are complete and accurate. Our UCA solution provides hospitals with detailed documentation, an analysis of the impact that your Worksheet S-10 results will have on uncompensated care and EHR incentive payments, and benchmarking against peer hospitals.