iqtsupport, Author at DeBrunner & Associates

Medicaid and Children’s Behavioral Health

In response to the growing behavioral health challenges children face, including the need for inpatient hospitalization, the country’s Medicaid directors recently addressed the question of how Medicaid can best help tackle this challenge. The directors thought their programs could be most helpful in three ways: preventing crises by providing care and supports improving specialized inpatient psychiatric care supporting the return of patients to the community Learn more about how the Medicaid directors think this can be done and what some of them already are doing in the National Association of Medicaid Directors blog article “How Medicaid is Making a Difference [...]

iqtsupport2022-11-15T06:00:44-05:00November 15, 2022|Medicaid|

Federal Health Policy Update for November 10

The following is the latest health policy news from the federal government for the week of November 7 to 10. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published a notice advising teaching hospitals that they have until November 18 to ask Medicare to reconsider their per resident amounts or resident caps as shown in the Hospital Cost Report Information System (HCRIS) associated with cost reports that, as of July 1, 2022, were not reopenable. Learn more from this CMS notice. Due to an unplanned system outage of [...]

iqtsupport2022-11-10T16:23:21-05:00November 10, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

iqtsupport2022-11-10T06:00:51-05:00November 10, 2022|Affordable Care Act, Uncategorized|

Innovation Center Updates Strategy

The Center for Medicare and Medicaid Innovation has updated its strategy for person-centered innovation. The Innovation Center’s new strategy document, “Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center’s Strategy,” outlines steps the agency hopes will foster greater coordination and cooperation between primary care providers and medical specialists through the introduction and refinement of new payment models. The new document outlines five strategic objectives: drive accountable care advance health equity support innovation address affordability partner to achieve system transformation In support of these objectives, the Innovation Center describes recent accomplishments – most them process measures rather [...]

iqtsupport2022-11-09T06:00:32-05:00November 9, 2022|Center for Medicare and Medicaid Innovation, CMMI|

MedPAC Meets

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: differences in quality measure results across Medicare populations policy options for increasing Medicare payments to primary care clinicians aligning fee-for-service payment rates across ambulatory settings mandated report: evaluation of a prototype design for a post-acute care prospective payment system supporting Medicare safety-net hospitals MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on Congress or the administration, MedPAC is [...]

iqtsupport2022-11-08T06:00:13-05:00November 8, 2022|hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3. Some of the language used below is taken directly from government documents. Medicare Payment Regulations In the past week CMS has published four regulations presenting how it will pay providers in the coming year. Outpatient prospective payment system – CMS announced a 3.8 percent increase for Medicare outpatient and ambulatory surgical payments. It also adopted its proposal to establish rural emergency hospitals as a new kind of hospital provider; removed 11 surgical procedures from its inpatient-only list and authorized [...]

iqtsupport2022-11-03T17:41:10-04:00November 3, 2022|340b, Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

A Bump in the Road for Telehealth?

Maybe. A new study suggests that telehealth follow-up may not be ideal after a visit to the hospital emergency department. According to a study based on a very limited scope of ED cases, … telehealth follow-up was associated with 28.3 more repeated ED encounters and 10.6 more return hospital admissions per 1000 patients compared with in-person follow-up. Further, … telehealth follow-up visits after ED encounters were associated with higher rates of repeated hospital visits even after controlling for presentation acuity, comorbidities, and sociodemographic factors. Learn more about how the study was conducted and what it found in the JAMA Network [...]

iqtsupport2022-11-01T06:00:07-04:00November 1, 2022|Telehealth|

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October 21 to October 27. Some of the language used below is taken directly from government documents. 340B Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year. According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year. CMS also will reprocess claims [...]

iqtsupport2022-10-27T17:06:24-04:00October 27, 2022|340b, Center for Medicare and Medicaid Innovation, CMMI, COVID-19, Medicaid, Medicaid regulations for long-term care, Medicare, Medicare reimbursement policy, MedPAC, post-acute care|

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years. Among the survey’s findings (in language taken directly from the Kaiser report): More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs Some states reported newly implementing or expanding MCO programs States also report continued use of other service delivery and payment system reforms Two-thirds of states are using strategies to improve race, ethnicity, and language data About one-quarter of states are tying MCO financial incentives to health [...]

iqtsupport2022-10-27T06:00:07-04:00October 27, 2022|COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, social determinants of health, Telehealth|

Hospitals to Continue to Face Staffing Challenges

While the number of health care employment openings is now declining and fewer health care workers are leaving their jobs, non-profit hospitals can expect to continue facing staffing challenges in the near future. At least that’s what Fitch Ratings says in a new report. “Despite some relief of late, U.S. not-for-profit hospitals are in for several challenging months with healthcare and social assistance job vacancies still high against a backdrop of low unemployment, according to Fitch Ratings in its labor dashboard for the sector,” the report said. Learn more from this Fitch Ratings news release.

iqtsupport2022-10-26T06:00:17-04:00October 26, 2022|hospitals|

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