Trauma Care Fund

Grants and Payments

Department of Health trauma grants – hospitals

Trauma Care Grants – Levels I and II

We disburse these grants each year to Level I and II designated trauma services. The grants subsidize undercompensated trauma care costs. We base the grant on a hospital's proportionate share of undercompensated trauma care. We use figures for bad debt, charity care and total patient revenue to calculate this grant. This information is taken from the most recent, complete calendar year of hospital patient data. The sum of the Injury Severity Scores (ISS) is extracted from our Trauma Registry for the same period. This includes cases that meet both the trauma registry inclusion criteria and one of the following criteria:

  • Adult trauma patients with an ISS of 13 or greater.
  • Pediatric trauma patients, under 15 years of age, with an Injury Severity Score of nine or greater.
  • All trauma patients received in transfer regardless of Injury Severity Score.

Figure 1 shows how this grant is calculated:

Sum of ISS x ((bad debt + charity care)/ total patient revenue) = N1

Sum of all trauma services N1s = NT

((N1 / NT) x total $ available for grant) = trauma service grant amount

Figure 1 - Levels I – II Trauma Care Grant Calculation

Trauma Care Grants – Levels III, IV, and V

We disburse these grants each year to Level III-V designated trauma services. The grants subsidize undercompensated trauma care costs. We base the grant calculation on designation level and trauma patient volume. The level bases are: $10,000 for Level III, $5,000 for Level IV and $2,500 for Level V. Volume data includes charges for trauma patients with a primary payer of Medicaid, self-pay, or charity care.

Figure 2 shows how this grant is calculated:

total charges for trauma patients with primary payer of Medicaid, charity care or self-pay = N1

Sum of all trauma services N1s = NT

((N1 / NT) x total $ available for volume portion of grant) = Volume

Volume + Level Base = trauma service grant amount

Figure 2 - Levels III – V Trauma Care Grant Calculation

Hospital Participation Grants – Levels I-V

We disburse these grants each year to all designated trauma services for both general and pediatric designations. The grant is to help offset the costs of participating in the trauma system. We use three criteria to calculate this grant:

  • Designation level, with weight given to higher levels.
  • Trauma patient volume, with weight given to higher volumes.
  • Location, with weight given to rural services.

The total grant funds available are divided among the criteria: 65 percent for level, 17.5 percent for volume and 17.5 percent for location. Each service is grouped by volume. The tables below show the volume group levels:

Acute Volume

Acute Volume High Medium Low

I

1000+ 500-999 0-499
II 500+ 200-499 0-199
III 400+ 100-399 0-99
IV 200+ 30-99 0-29
V 50+ 25-49 0-24

Pediatric Volume

Pediatric Volume High Medium Low
I-P 150+ 75-149 0-74
II-P 60+ 30-59 0-29
III-P 40+ 20-39 0-19

We base location on the most current population data from the Office of Financial Management.

Hospital Rehabilitation Participation Grants – Levels I and II

We disburse these grants each year to Level I and II designated trauma rehabilitation services for both general and pediatric designations. The grant is to help offset the costs of participating in the trauma system. We base the amount of the grant on level of designation only. Of the total grant funds available, 60 percent is for Level I services the remaining 40 percent is for Level II services. These amounts are then divided by the number of levels to give the individual grant amount.

Department of Health trauma grants – Prehospital

Medical Program Director Grant

We disburse these grants each year to all current medical program directors. The grant is to help offset their costs. Medical program directors provide medical oversight for emergency medical services and trauma prehospital personnel.

Prehospital Participation Grant

We distribute these grants each year to all trauma-verified prehospital agencies. The grant is to help offset the costs of participating in the trauma system. These costs can include equipment, training, supplies, and staffing. The individual grant amount is the total amount of funding divided by the number of active trauma verified credentials in December. The grant amount per agency for state fiscal year 2018 was $1,222. We email grant applications and instructions to trauma verified agencies in January each year.

Health Care Authority enhanced Medicaid payments

Supplemental Hospital Trauma Care Medicaid Distributions – Levels I, II, and III

The Health Care Authority (HCA) supports hospitals through supplemental Medicaid distributions for Levels I, II, and III. These payments apply to trauma cases that meet or exceed the injury severity score of 13 for adults and nine for children less than 15 years of age, and to cases received in transfer. The agency makes five supplemental hospital distributions for each state fiscal year (the “service year”). The supplemental payment each hospital receives is based on each participating hospital's percentage share of all eligible trauma claims for the service year to date. Beginning in state fiscal year 2014, hospital distribution calculations will include both fee-for-service claims and managed care encounter data.

Increased Physician Trauma Care Medicaid Payments

The Health Care Authority (HCA) supports clinical providers through increased physician payments. HCA's payments apply to trauma cases that meet or exceed the Injury Severity Score of 13 for adults and nine for children less than 15 years of age, and to cases received in transfer. Physicians and other clinical providers receive increased payments for trauma services on a claim-specific basis. Claims for professional services are reviewed at the line item level; some procedures (e.g., laboratory) aren't eligible for increased payment. For an eligible procedure, the payment amount is the HCA's maximum allowable fee multiplied by the enhancement percentage.

Injury Severity Score (ISS)

The Injury Severity Score is used to describe patients with multiple injuries. The abbreviated injury scale is used to score the severity of a patient's injuries. The abbreviated injury scale is used to classify each injury by body region on a scale from 1 to 6 – the higher the number the more severe the injury. The abbreviated injury scale is used to calculate the injury severity score. The sum of the squares of the highest abbreviated injury scale scores, in the top three most severely injured body regions, gives the injury severity score.

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