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Practice paper

Medicare reimbursement uncompensated care strategies

Jay Sutton and Ron Wolf
Management in Healthcare: A Peer-Reviewed Journal, 4 (3), 274-283 (2020)
https://doi.org/10.69554/FMUZ9782

Abstract

As the ageing population in the US expands, more people will become health system users, and the number of uninsured will increase. Uncompensated care will continue to be a risk to healthcare institutions, and collaboration among the financial functions of institutions is essential to ensure healthcare providers do not miss Medicare and Medicaid reimbursement opportunities. This article identifies what healthcare organisations should be focusing on to drive reimbursement.

Keywords: uncompensated care; Medicare reimbursement; Medicare cost report; Centers for Medicare and Medicaid Services (CMS); 340B

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Author's Biography

Jay Sutton FACHE, CNRA, is a consulting principal at Crowe LLP, an accounting, consulting and technology firm with offices around the world. Working within the firm’s healthcare services group, Sutton has more than 25 years of experience in the healthcare industry. He leads healthcare finance and reimbursement consulting services at Crowe, serving a range of clients, including hospital and health systems, long-term care and physician practices. His experience includes financial analysis and projections, financial process improvements, decision support and analytics, net revenue budgeting and reporting and wage index and occupational mix calculations. Prior to joining Crowe, Sutton held roles at several large health systems in business development and data analysis and worked at a Big 4 firm.

Ron Wolf CHFP, is a Consulting Senior Manager at Crowe LLP, an accounting, consulting and technology firm with offices around the world, within the healthcare services group. With more than 20 years of healthcare industry experience, Wolf specialises in researching and reporting on complex regulatory reimbursement issues. He works with clients on uncompensated care reporting, disproportionate share hospital/supplemental security income issues and physician time reporting and contract compliance. Prior to joining Crowe, Wolf held roles at a Big 4 national healthcare advisory services practice and at two Medicare fiscal intermediaries in the areas of audit and reimbursement, cost report appeals and reopenings.

Citation

Sutton, Jay and Wolf, Ron (2020, March 1). Medicare reimbursement uncompensated care strategies. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 4, Issue 3. https://doi.org/10.69554/FMUZ9782.

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cover image, Management in Healthcare: A Peer-Reviewed Journal
Management in Healthcare: A Peer-Reviewed Journal
Volume 4 / Issue 3
© Henry Stewart
Publications LLP

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