Health Care Payment Reform Center

Cost Report Preparation & Review

Preparation and review of annual cost reports is where BKD National Health Care Group’s Medicaid reimbursement services truly shine. We help Medicare and Medicaid providers keep up with changes in reporting requirements while also completing reports timely. Our services help you interpret the results of your cost reports.

Integrated Delivery & Large Urban Systems

BKD National Health Care Group’s approximately 1,000 hospital and health system clients include multiple-hospital systems, free-standing urban health systems and teaching hospitals. We’re experienced in the reimbursement and cost report issues important to these systems, including disproportionate share, Indirect Medical Education (IME), Graduate Medical Education (GME) and bad debts.

Our hospital consultants frequently speak on reimbursement topics at state, regional and national conferences, and we regularly send out industry-specific articles on reimbursement issues for large facilities.

Our more than 50 years of experience with reimbursement issues enables us to help large health care systems make smart business and financial decisions. Our solutions include:

  • Preparing cost reports
  • Enhancing disproportionate share, including electronic verification of eligible days
  • Helping implement Direct Medical Education (DME) programs
  • Helping identify and claim bad debts not identified by the hospital’s own tracking systems
  • Performing wage index studies
  • Performing feasibility studies
  • Helping facilitate board retreats and provide training
  • Assisting with facility and medical staff planning
  • Performing market share studies
  • Recommending improvements to case management reimbursement
  • Recommending improvements to post-acute care reimbursement
  • Helping assess compliance and risk
  • Providing support for the charge description master and coding billing
  • Assisting with strategic planning
  • Analyzing various service lines to help determine where systems make and lose money

Critical Access Hospitals

Click here to learn more about our in-depth CAH reviews.

Rural Hospitals

Because there are so many reimbursement issues and strategies unique to rural hospitals, we frequently find them overlooking appropriate reimbursement options. The foundation of BKD National Health Care Group’s hospital practice has been rural hospitals, including rural referral centers, sole community hospitals, Medicare-dependent hospitals and critical access hospitals.

We regularly speak on rural hospital reimbursement strategies at state, regional and national conferences, and we regularly send out industry-specific articles on rural hospital reimbursement issues.

PPS Hospitals

It’s important for prospective payment system (PPS) hospitals to evaluate key cost report reimbursement aspects, including interns and residents, wage index, Medicare bad debts, disproportionate share hospital (DSH), diagnosis-related groups (DRG) transfer payments and pass-through programs.

Our more than 50 years of experience with issues unique to rural hospitals enables us to provide insights and ideas to help you make smart reimbursement decisions. Our solutions include:

  • Preparing cost reports
  • Evaluating special rural designations and other payment exceptions
  • Performing capital financing analyses and feasibility studies
  • Recommending improvements to case management reimbursement
  • Recommending improvements to post-acute care reimbursement
  • Evaluating reimbursement changes created by new laws and regulations
  • Assessing compliance and risk
  • Recommending improvements to swing-bed operations and reimbursement
  • Analyzing interim rates and settlements
  • Providing support to charge description master and coding billing
  • Assisting with strategic planning

Baptist Health

“BKD has some of the most qualified health care auditors and Medicare cost report experts in the industry.”

— Bob Roberts, Senior Vice President & CFO
Baptist Health
Little Rock, Arkansas


Iberia Medical Center

“BKD knows more about health care than any other CPA firm I have dealt with. BKD’s customer service is excellent, and the staff are readily accessible. I trust BKD for expertise on audit, cost report, consulting or compliance issues.”

— Stephanie Kirk, CFO
Iberia Medical Center
New Iberia, Louisiana


Crider Health Center

“BKD is a leader in the auditing, cost reporting and compliance industry. They offer valuable training opportunities and bring education to each audit review. I can always count on sound advice and guidance in the complex area of FQHCs and cost reporting.”

— Beth Smith, Vice President of Finance & Facilities
Crider Health Center
Wentzville, Missouri


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