REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
June 23, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Charge Description Master Increase
End
RECOMMENDATION(S)
Recommendation
Authorize Arrowhead Regional Medical Center to amend and increase the rates in the Arrowhead Regional Medical Center Charge Description Master by 5%, effective July 1, 2026.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost). The Charge Description Master (CDM) will allow Arrowhead Regional Medical Center (ARMC) to bill for all charges consistent with operational expenses and third-party reimbursements with the commitment toward full cost recovery. This increase is estimated to generate approximately $2.8 million in additional net revenue per year, which will be utilized to offset anticipated increased costs to ARMC’s operations.
BACKGROUND INFORMATION
Approval of this item will authorize ARMC to increase the rates on the CDM by 5%, which would keep ARMC’s charges equivalent to area market rates. The adjustment in patient charges will correspond to and result in an increase in reimbursement from non-governmental payors.
The 5% increase of charges will assist in recovering necessary revenue needed to provide healthcare for county residents. The cost of medical care is affected by the implementation of costly new procedures and drugs. Additionally, the minimum wage increase in California impacts healthcare costs.
Through the County’s non-competitive procurement process, Hospital Pricing Specialists, LLC was awarded a contract in October 2025 for an amount not to exceed $100,000 for one year to assess ARMC’s Charge Description Master (CDM) against comparable hospitals within the market area. As part of this strategic analysis, the contractor provided market-based recommendations for chargemaster pricing.
The analysis supports a projected 5% increase in gross charges while optimizing net revenue opportunities through a targeted pricing strategy that considers service line categories, procedure utilization, and commercial payer contract structures.
The CDM is the price list for services and items provided at ARMC facilities and includes the comprehensive listing of billing codes for such services and items. ARMC is required to have a CDM that contains the billing Current Procedural Terminology, Healthcare Common Procedure Coding Systems, revenue codes and charges for patient supplies, procedures, daily room rates and clinical rates for services performed at and billed by ARMC.
On October 3, 2023 (Item No. 10), The Board of Supervisors (Board) approved the CDM, which reflects the billable charges for inpatient, facility, ancillary, and certain professional services.
On February 27, 2024 (Item No. 13), the Board approved an amendment and increase to the rates in the Charge Description Master by 8%, effective March 1, 2024.
Under Health & Safety Code Section 1473, the Board in each county may fix the rates charged to patients admitted to any county hospital.
ARMC recommends that the Board, as the governing board of ARMC, approve the increase to the CDM rates as it will allow ARMC to bill for its services consistent with surrounding hospitals and to provide for the health and social services needs of county residents by providing more accurate billing for patients and mitigate against increased costs to ARMC’s operations.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Daniella Hernandez, Deputy County Counsel, 387-5455) on May 27, 2026; ARMC Finance (Chen Wu, Finance and Budget Officer, 580-3165) on May 29, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on June 3, 2026.