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 updated its analysis of Medicare enrollment data to reflect Medicare enrollment as a percentage of each county’s total population and the split for Medicare between traditional fee-for-service and Medicare Advantage (MA). Statewide, nearly 22% of the total population is enrolled in Medicare.
Total Medicare enrollment is approximately 2.21 million, with 60% of beneficiaries enrolled in a MA plan. MA enrollment as a percentage of total Medicare enrollment varies by county, ranging from 43% to 75%. November enrollment spread across 49 MA plans with up to 32 plans covering beneficiaries in some Michigan counties.
The MHA recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the 2025 MA proposed rule. The MHA continues to urge the CMS to hold MA plans accountable for complying with provisions of the 2024 MA final rule and recommend the CMS impose intermediate sanctions, civil monetary penalties or terminate contracts of noncompliant plans.
Members with enrollment questions should contact Health Finance at the MHA.