How can you keep score while Congress considers multiple proposals to repeal and replace the Affordable Care Act? The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals: you pick the proposals you want to compare and you select the aspects of those proposals that interest you. Find this new interactive tool here, on the web site of the Kaiser Family Foundation.
With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider. Among them are: giving states greater flexibility in the design and implementation of their own Medicaid programs requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments limiting benefits employing incentives to encourage healthy behaviors The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years. Learn more about some of the options Congress will [...]
A new study has concluded that the bundled payments programs being tested by Medicare reduce health care costs while improving the quality of care. The study covered Medicare Bundled Payment for Care Improvement (BPCI) results for the past four years and includes the Medicare hip and knee replacement bundled care program. And contrary to another recent study, this report did not find any increase in the volume of procedures during the study period. To learn more about the study’s methodology and findings, go here to read “Debunking the Argument that the Bundled Payment for Care Improvement Program (BPCI) Contributed to [...]
A coalition of 35 patient, physician, and hospital groups has written to new Secretary of Health and Human Services Tom Price and asked him to continue the federal government’s exploration of new ways to deliver and pay for Medicare services but to seek certain improvements in how those efforts are undertaken. The coalition Healthcare Leaders for Accountable Innovation in Medicare asked Secretary Price for a reformed Center for Medicare and Medicaid Innovation so that it operates with … appropriately-scaled, time-limited demonstration projects, greater transparency, improved data-sharing, and broader collaboration with the private sector. The coalition also called for CMMI to [...]
One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts. For a closer look at Medicaid value-based purchasing, [...]
With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such [...]
Federal oversight of the manner in which states pay for Medicaid-covered managed long-term services and supports and of the data states use to set the rates for those services and supports is lacking, according to a new study by the U.S. Government Accountability Office. In a review of such practices in six states, GAO found that states are not adequately linking payments and penalties to performance toward achieving MLTSS goals for providing more care in the community and are using outdated data to set rates that federal regulations require to be “appropriate and adequate.” Learn more about what the GAO [...]
The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The Cures Act changes this by instructing HHS to set different [...]
Congress may use the federal budget reconciliation process to repeal some aspects of the Affordable Care Act. But what is the budget reconciliation process and how does it work? Kaiser Health News has created a brief video, with an accompanying transcript, that explains. Find that video here.
Last month Congress passed the Expanding Capacity for Health Outcomes Act. The new law calls for the U.S. Department of Health and Human services to study a New Mexico project that employs distance learning to enhance the ability of the medical community to serve medically underserved areas. Launched by the University of New Mexico in 2003, Project ECHO takes advantage of telehealth techniques to employ medical specialists who consult via videoconference with primary care providers. This approach can be employed to help patients in rural and underserved rural areas and to assist those with limited mobility who have difficulty traveling [...]