SHOPP assessment rate decreasing for 2020

Posted on: 12/13/19

Oklahoma hospitals in the Supplemental Hospital Offset Payment Program (SHOPP) will pay an assessment of 2.3% of net hospital patient revenue in 2020, a decrease from the 2019 rate of 2.8%.

SHOPP was created and implemented in 2011 for the purpose of assuring access to quality care for Oklahoma Medicaid members.

Supplemental payments to hospitals from this program will total $445 million in 2020. This amount is calculated to reach aggregate upper payment limits of federal matching. Supplemental payments are distributed in proportion to inpatient and outpatient claims payments of the hospitals assessed in the program.  

The assessment rate decreased in part because the federal matching rate for Oklahoma Medicaid has increased. The federal share of Oklahoma Medicaid payments increased from 62.4% to 66% on Oct. 1, 2019, and is expected to increase again on Oct. 1, 2020. Federal matching rates are recalculated annually, and are based on the states’ relative per capita income.
The assessment rate is applied to participating hospitals’ net patient revenue from their 2018 Medicare cost report.

Also contributing to the decrease in SHOPP assessment is an increase in Medicaid claims payment rates funded by the Legislature. Payment rates for hospitals and most other SoonerCare providers were increased by 3% in October 2019, and another 5% in October 2020.

Critical access hospitals do not pay the SHOPP assessment, but receive supplemental funding from the program. (Rick Snyder)