What A Hospital Tax Could Look Like in Texas

Texas hospitals are abuzz over quiet conversations in the Senate about a possible "quality assurance fee," or tax on hospitals to raise revenue to beef up Medicaid. Such a tax looks highly unlikely; lawmakers have said the hospitals would largely have to be on board before they'd risk it — and the hospitals aren't there. But the Health and Human Services Commission contracted with Deloitte earlier this year to run the numbers on what such a tax could cost individual hospitals in the 2012-13 biennium, and how it could affect those hospitals' bottom lines.

As a baseline, Deloitte used a 3.4 percent tax on hospitals' gross receipts, and assumed hospitals were being reimbursed by Medicaid at a minimum "Standard Dollar Amount," or hospital payment rate. The result? Hospitals with large populations of Medicaid patients — like those along the Texas-Mexico border and in the state's urban centers — come out way ahead in this particular analysis. Hospitals that don't would lose many millions of dollars. Use the data projections below to see what hospitals would have to pay in taxes, and whether they'd come out ahead or behind in total revenue, if this particular quality assurance fee were on the books.

* Change in revenue, assuming a minimum "Standard Dollar Amount," or hospital payment rate.

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