Upstate NY Hospitals Receiving Reimbursements

SARATOGA COUNTY — Congressman Paul Tonko and U.S. Senate Majority Leader Charles Schumer announced the finalized rule announced by the Centers for Medicare & Medicaid Services (CMS) that would address a longstanding inequity, known as the Medicare Wage Index (MWI), that they say has short-changed Capital Region hospitals in Medicare reimbursement rates. 

This formula adjustment will bring more than $190 million annually to Capital Region hospitals and an estimated $967+ million across New York State each year.

“This fix to the formula means an influx of hundreds of millions to our local hospitals — long burdened by the added strain from the COVID-19 pandemic — to address staff pay and retention, update medical equipment and technology, and further invest in patient care,” said Tonko, in a statement released jointly with Schumer.

For years, the Medicare Wage Index for the Capital Region has rested around 86 cents on the dollar, while nearby regions in New York, Massachusetts, and Connecticut were provided much higher rates. The finalized CMS rule for the FY24 Inpatient Prospective Payment System (IPPS) will bring the Capital Region’s MWI up to around $1.22, delivering more than $190 million in federal funding to NY-20 hospitals each year. 

The new FY24 Inpatient Prospective Payment System (IPPS) rule will now increase the Capital Region’s adjustment to 122 percent of what the average hospital receives in wage adjustments, acknowledging that the region needs much higher than average wages to compete and bring in the best providers, according to the statement. 

The specific impact on Saratoga Hospital is just over $2.7 million.