Uncompensated Care Analytics

Healthcare Payment Specialists launched its Uncompensated Care Analytics (UCA) product in 2015. Our UCA solution provides hospitals with the core data points needed to complete Worksheet S-10, detailed documentation to expedite the audit process, an analysis of the impact that Worksheet S-10 results will have on your uncompensated care payments and benchmarking against peer hospitals.

This solution was created in anticipation of Worksheet S-10 becoming an important component of the DSH formula—an event that the Centers for Medicare and Medicaid Services (CMS) has consistently signaled since 2015.

CMS took the step to introduce Worksheet S-10 into the uncompensated care payment formula in the FY 2017 Hospital Inpatient PPS Proposed Rule. This formula would have incorporated Worksheet S-10 as a component starting in FY 2018. While the final version of the rule did not include the revised formula, CMS clearly signaled its intent to include Worksheet S-10 in the uncompensated care payment formula.

In April 2017, CMS released the FY 2018 Hospital Inpatient PPS Proposed Rule. This rule reintroduces Worksheet S-10 into the uncompensated care payment formula. Unlike 2017, CMS attached additional details that makes it clear that they intend to include the new formula in the final rule for 2018.

What This Means for Hospitals

The inclusion of Worksheet S-10 in the 2017 and 2018 proposed rules, especially the clear language in the 2018 rule regarding its implementation, demonstrates that the inclusion of Worksheet S-10 as a key component of the uncompensated care formula in the near future is inevitable.

The uncompensated care payment formula in the 2018 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 2018 proposed rule, FY 2014 will be the initial reporting period incorporated in the formula. One thing to keep in mind is that CMS has already stated that hospitals will not have the ability to revise their Worksheet S-10s from FY 2014.

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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.

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