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Health Commission adopts FY15-16 patient fee schedule after discussion of cost-to-charge ratios
Summary
Commissioners approved the Department of Public Health's proposed patient rates for FY15-16 and FY16-17 following discussions about OSHPD cost-to-charge ratios and requests for comparative target data.
Anna Okubo, deputy financial officer, presented the proposed patient rates for fiscal years 2015-16 and 2016-17, describing them as published charges for hospitals, clinics and behavioral health programs that are distinct from actual reimbursement amounts paid by Medicare and Medi-Cal. Okubo said many patients pay adjusted amounts under sliding-fee schedules.
CFO Greg Wagner and commissioners discussed the department's cost-to-charge ratio goal and historical position. Wagner said a prior analysis found the department had been in the mid-30s (cost-to-charge) and is now around 30, working to align closer to peer hospitals. Commissioners asked staff to provide the target and historical numbers to give context for future rate decisions.
After discussion, the commission moved, seconded and voted unanimously to approve the fee schedule for submission.
The record shows the commission requested a clearer context for rate-setting and that staff will provide historical and target cost-to-charge ratios in a follow-up to help the commission evaluate future changes.
