NASHP Releases Hospital Cost Tool to Calculate Commercial Payment Breakeven Rates
The National Academy for State Health Policy (NASHP) has released a hospital cost tool that allows state payers to calculate commercial payment breakeven rates. The tool helps states and other payers analyze hospital pricing by determining the minimum commercial rates needed to cover costs when considering Medicare and Medicaid payments. This analysis is relevant for states evaluating hospital payment adequacy and negotiating commercial rates, which indirectly affects Medicaid programs through cross-subsidization dynamics and hospital financial viability. The tool is available now for state use.
States can use this tool to assess whether Medicaid payment rates are contributing to cost-shifting that drives up commercial rates, which affects overall hospital financial stability and willingness to participate in Medicaid managed care networks.
Finance · Managed Care
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