Under nearly impenetrable hospital payment rules, Medicare must reimburse a state’s urban hospitals for employee wages at least as much as it reimburses its rural hospitals. As a result, Nantucket sets the floor for wage reimbursements at hospitals across the state. And because Nantucket’s wages are high, due to its remote island location and steep cost of living, that has created bonuses for many other Massachusetts hospitals in recent years.
Not this year. Consultants hired by Partners made several errors that led to lower wages being reported to Medicare for Nantucket Hospital. They overestimated hours, thereby reducing the hourly rate, and did not include enough higher-paid physician hours and overtime pay, according to an e-mail from the Massachusetts Hospital Association obtained by the Globe.
Those mistakes, combined with another smaller adjustment to Nantucket’s wages, would result in a “steep and extraordinarily serious’’ decline in Medicare payments, wrote the association’s general counsel, Timothy Gens, in the e-mail. He said “the situation is further complicated by the fact that the [Medicare] deadline for corrections has passed.’’ The rates affect the next fiscal year, beginning in October.