To assist clients with their budgeting process, SCA offers an estimating tool to more accurately determine their expected payments for Medi-Cal inpatient fee-for-service business. These payments can be significantly different from year- to- year as a result of payment policy revisions that are made by the Department of Health Care Services.

The State of California requires hospitals to prepare and submit quarterly and annual reports to the Office of Statewide Health Planning and Development (OSHPD). Over time the importance of this data source has grown from being a research tool to conveying a public image for the hospital, especially with respect to the level of charity care a hospital is providing. Now the data is also used for multiple payment programs and is relied upon in many of the supplemental payment programs payment methodology. Focusing on providing accurate information to OSHPD has become critical to ensure hospitals receive appropriate level of payments.

Medi-Cal Fee-For-Service APR-DRG Payment Projections

• Project the upcoming year’s expected Medi-Cal inpatient fee-for-service payments applying the most recent policy decisions and technical updates to the latest full year payment data
• Provide impact analysis and identify areas of significant change

 Hospital Financial Assistance (Charity Care) Policy Analysis

• In-depth policy, procedure and practice assessments
• Establishing a documented audit process for identifying eligible patients
• Capturing and accounting for data used to meet government required reporting
• Ensuring that the data related to the patients qualifying under the charity care policy is properly reported and supported on the Medicare Worksheet S-10 that is used when determining Medicare DSH payments

OSHPD Accounting and Reporting System Projects

• Report Preparation and Submission
• OSHPD Accounting and Mapping Analysis
• OSHPD Data analysis