Dive Brief:
- Math errors submitted to Medicare by the Massachusetts-based Nantucket Cottage Hospital could lead to a substantial reduction in Medicare payments next fiscal year (beginning in October) and result in 2,000 layoffs throughout the Bay State, the Boston Globe reported.
- Because Medicare rules dictate that Massachusett's urban hospital reimbursements for employee wages are relative to its rural hospitals, the errors set the bar for the state's wage reimbursement.
- Partners Healthcare, a nonprofit hospital and physician network, owns the 19-bed rural hospital and hired consultants who overestimated hours, thus reducing the hourly rate.
Dive Insight:
The consultants also failed to include enough high-paid physician hours and overtime pay, according to the Globe. The errors could also cause state hospitals to lose about $160 million in Medicare reimbursements. Of the potential 2,000 layoffs, 1,800 of which could occur in community hospitals, according to Steven Walsh, a former state representative and Massachusetts Council of Community Hospitals' executive director.
Out of the $160 million reduction in Medicare reimbursements, approximately $115 million can be attributed to math errors, the Globe noted. Medicare auditors made separate findings that resulted in the remaining $45 million reduction.
Partners HealthCare Spokesman Rich Copp told the Globe that Partners did not recognize the consultants had made several math errors until mid- to late March. The organization sent corrected data on April 5, nearly two months after the Medicare data corrections deadline.
However, Copp stated Medicare should use the corrected data. “Any other course of action will hurt hospitals in every corner of the state,’’ he said.
According to Partners, if Medicare does not use the corrected data, its North Shore Medical Center could see a $18 million reduction and Baystate Medical Center in Springfield could see a $25 million reduction.
Walsh told the Globe Medicare has, “broad discretion to correct the error. It would be really unfortunate and unacceptable to risk losing millions of dollars and thousands of jobs over a math error.’’
CMS stated it is reviewing the hospital's appeal, Modern Healthcare reported.