Keckley says Deloitte is forecasting that insurance exchange reimbursements could be at or below the commercial payment rate, but probably lower. "We think the exchanges will pay providers between 90% to 120% of Medicare rates, most likely 90% [of the Medicare rate]. So there will be a lot of focus on the erosion of bottom line," he says.
This means financial leaders need to have a handle on their local and national political scenes and must make educated guesses on how the PPACA ruling will be interpreted by their state, as well as how it could impact reimbursements and patient volumes. In other words, they need to know everything.
All of this should make budget forecasting increasingly difficult for CFOs at a time when hospitals and health systems need more financial certainty than ever to pursue plans for growth, improve patient care, and make required technology upgrades. Being the Chief Everything Officer won't be easy.