Health Care Payment Reform Center
Health Care Industry Brochure

Cost Reports & Reimbursement

BKD National Health Care Group is one of the largest providers of Medicare and Medicaid cost report preparation services in the country. We have prepared thousands of cost reports for hospitals and health systems of all sizes and types, including integrated delivery and large urban health systems, rural facilities and critical access hospitals.

Preparation of annual cost reports is the foundation of BKD National Health Care Group’s Medi-caid reimbursement services. We help Medicare and Medicaid providers keep up with changes in reporting requirements while completing reports timely. Our services help providers like you interpret the results of your cost reports so you know if you make or lose money on individual service lines.

For some providers, such as critical access hospitals and community health centers, the cost report has a direct impact on reimbursement received from Medicare and Medicaid. For many other providers, unique reimbursement provisions can still affect reimbursement if properly pre-sented on the cost report. Our CPAs and advisors can assist with analyzing your reimbursement situation so you understand how you are being paid compared to the cost of rendering services to Medicare and Medicaid patients.

Integrated Delivery & Large Urban Systems

BKD National Health Care Group’s approximately 1,000 hospital and health system clients include large multiple-hospital systems, large free-standing urban health systems and teaching hospitals. We are experienced in the reimbursement and cost report issues unique to these systems, including disproportionate share, Indirect Medical Education (IME) and 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 40 years of experience with reimbursement issues enables us to help large health care systems make smart business and financial decisions. Our solutions include:

  • Prepare cost reports
  • Enhance disproportionate share, including electronic verification of eligible days
  • Help implement Direct Medical Education (DME) programs
  • Help identify and claim bad debts not identified by the hospital’s own tracking systems
  • Perform wage index studies
  • Perform feasibility studies
  • Help facilitate board retreats and provide training
  • Assist with facility and medical staff planning
  • Perform market-share studies
  • Recommend improvements to case management reimbursement
  • Recommend improvements to post-acute care reimbursement
  • Help assess compliance and risk
  • Provide support for charge description master and coding billing
  • Assist with strategic planning

Critical Access Hospitals

A significant ingredient to financial success as a critical access hospital (CAH) is the preparation of an accurate and compliant Medicare and Medicaid cost report. BKD helps approximately 150 CAHs identify opportunities to accurately capture reimbursement they are entitled to receive and improve compliance.

We are speakers on CAH reimbursement topics at state, regional and national conferences, and we regularly send out industry-specific articles about CAH reimbursement issues.

Our 40 years of experience with reimbursement issues enables us to help CAHs make smart business and financial decisions. Our solutions include:

  • Assist with the decision to pursue the CAH designation
  • Perform capital financing analyses and feasibility studies
  • Perform cost allocation studies
  • Recommend improvements to swing-bed operations and reimbursement
  • Analyze interim contracts and settlements
  • Provide support for charge description master and coding billing
  • Assist with strategic planning

Rural Hospitals

Because there are so many reimbursement issues and strategies unique to rural hospitals, we frequently find hospitals 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.

Our more than 40 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:

  • Prepare cost reports
  • Evaluate special rural designations and other payment exceptions
  • Perform capital financing analyses and feasibility studies
  • Recommend improvements to case management reimbursement
  • Recommend improvements to post-acute care reimbursement
  • Evaluate reimbursement changes created by new laws and regulations
  • Assess compliance and risk
  • Recommend improvements to swing-bed operations and reimbursement
  • Analyze interim contracts and settlements
  • Provide support to charge description master and coding billing
  • Assist with strategic planning

Eddie Marmouget

National Practice Leader
417.865.8701

Kimberly McKay

Managing Partner
713.499.4600

Kevin Gore

Partner
918.584.2900

David Kottak

Partner
502.581.0435

McCune-Brooks Regional Hospital

“The BKD Corporate Finance team did an excellent job representing the financial interest of McCune-Brooks Regional Hospital in the transaction. The Board of the city-owned, not-for-profit hospital had a fiduciary duty to ensure long-term access to health care in the community. Although we knew who the likely party was going to be in the transaction, BKDCF used their expertise in health care transactions to negotiate the financial components of the transaction from a position of strength. The BKDCF team did an excellent job managing the process, helping to achieve an outcome that was approved unanimously by the Board."

— Doug Culver, CFO
McCune-Brooks Regional Hospital
Carthage, Missouri


Jordan Valley Community Health Center

“I have used BKD at two different facilities for a full range of financial services. Their professionals have provided us with audit, tax, coding and billing and cost report services and have assisted us in operations management and revenue enhancement. Routinely, implementation of their recommendations had a positive influence on the financial outcomes of our programs.”

— Brooks Miller, Executive Director
Jordan Valley Community Health Center
Springfield, Missouri


Excell Home Care

“The people at BKD are a great asset. Our advisor is easy to work with and very knowledgeable. He is accessible and takes the time to teach and advise, showing he really cares about our business.”

— Mina Acquaye, Chief Executive Officer
Excell Home Care
Oklahoma City, Oklahoma


Catholic Health Partners

“Catholic Health Partners is an important client—that’s the clear message I get from BKD. From partner interaction to the hands-on involvement and accessibility of senior-level and other personnel, theirs is an adept team effort that works very well. They are highly responsive to our needs. I also appreciate the wide range of BKD services I can use for more complex business issues.”

— Scott D. Schitter, CPA, Corporate Director of Reimbursement & Tax Services
Catholic Health Partners
Cincinnati, Ohio

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