Healthcare Reimbursement and Financing
Hospital and health system financing and reimbursement is complex and affects access to care in communities across Michigan. The MHA works on behalf of its members to achieve fair and adequate healthcare funding, and also helps hospitals communicate financial issues to the communities they serve.
Federal and State Hospital Finance Issues
The MHA monitors and engages with federal and state agencies that develop financing rules that direct hospital payments. These include payments for inpatient and outpatient services, value-based payments and fee-for-service payments. The MHA provides comments on key policy issues that impact the entire membership and/or significant subsets of the Michigan hospital community. MHA comments are shared with the membership via Monday Report and direct email communications to assist members in developing their own comments to governmental agencies.
Hospital Association Reporting Portal (HARP)
HARP is a secure online portal that allows MHA-member hospitals to access hospital-specific information while also providing an upload functionality for submitting documentation to the MHA. For any questions contact the Finance Policy Department.
Medicare Advantage Enrollment
The MHA recently expanded its analysis of enrollment data to reflect Medicare and Medicaid enrollment as a percentage of each county’s total population and the split for Medicare and Medicaid between fee-for-service and managed care organizations. Statewide, nearly 22% of the total population is enrolled in Medicare and 32% enrolled in Medicaid.
Total Medicaid enrollment, including the Healthy Michigan Plan, is 3.2 million as of April 2023, with 71% of beneficiaries enrolled in one of nine managed care plans. The MHA will update this data monthly as we monitor the impact of the Medicaid redetermination process that requires eligibility be redetermined for all enrollees over the next 12 months. The Michigan Department of Health and Human Services began the process April 1, with some enrollees expected to lose coverage July 1.
Total Medicare enrollment is 2.17 million with 59% of beneficiaries enrolled in a Medicaid Advantage (MA) plan. April enrollment is spread across 48 MA plans with up to 28 plans covering beneficiaries in several Michigan counties. The MHA will also update this data monthly as Michigan’s population continues to age and MA enrollment continues to grow.
Members are encouraged to review the MHA’s COVID-19 PHE webpage for information about the end of the PHE and additional resources.
Members with enrollment questions should contact Health Finance at the MHA.