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On Second Thought, CMS Decides to Share Hospital Performance Data

After originally proposing not to publish certain recent hospital performance data because it feared it might be skewed by COVID-19-related challenges, the Centers for Medicare & Medicaid Services has decided to go ahead and publish that data – but not to use it in Medicare payment calculations. Under Medicare’s hospital-acquired condition program, hospitals are rated on their performance on ten safety indicators.  Regulators, however, feared that doing so based on hospital performance during the pandemic might penalize hospitals whose communities were especially hard hit by the pandemic.  Patient safety groups opposed CMS’s April proposal to withhold the data and the [...]

Rural Residents Turning to Urban Hospitals in Growing Numbers

Residents of rural areas are choosing to seek care in urban hospitals in growing numbers, according to a new study. And while this trend has been accelerated by rural hospital closures, it is occurring even in areas where rural hospitals have not closed. Among the reasons for this migration from rural to urban hospitals are physician referrals and perceptions about the cost and quality of care. Learn more from the University of North Carolina Gillings School of Global Public Health article “Urban hospitals see rising admissions from rural Medicare patients,” which includes a link to additional resources.

2022-08-04T06:00:02-04:00August 4, 2022|hospitals|

Federal Health Policy Update for Tuesday, August 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Tuesday, August 2.  Some of the language used below is taken directly from government documents. White House The White House has announced two new actions to address the youth mental health crisis:  it will award nearly $300 million from the FY 2022 bipartisan omnibus agreement to expand access to mental health services in schools and it will encourage governors to invest more in school-based mental health services.  Learn more about this effort, including the individual funding components of the $300 million in new [...]

Congress Seeks Bigger Bump for Medicare Hospital Payments

More than 140 members of Congress have written to Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure asking her to implement a bigger increase in Medicare payments for hospital inpatient services than the agency has proposed for FY 2023. According to separate bipartisan letters from House and Senate members, the proposed FY 2023 increase – 2.8 percent – fails to reflect inflation and rising health care staffing costs.  The letter signed by 112 House members states that We worry the proposed payment updates do not accurately reflect today’s cost of patient care and, when tethered with other policy changes [...]

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27.  Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2023 CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April.  To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself. CMS also has finalized its [...]

Federal Health Policy Update for Wednesday, July 20

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 20.  Some of the language used below is taken directly from government documents. White House The White House COVID-19 response team has briefed the press about the administration’s latest efforts in the response to COVID-19.  Find a transcript of that teleconference briefing here. COVID-19 Public Health Emergency HHS Secretary Xavier Becerra has renewed the COVID-19 public health emergency effective July 15. Centers for Medicare & Medicaid Services CMS has released its proposed Medicare outpatient prospective payment system regulation for calendar year 2023.  [...]

Federal Health Policy Update for Tuesday, July 12

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, July 12.  Some of the language used below is taken directly from government documents. White House The White House has issued an executive order on protecting access to reproductive health care services. Find that executive order here. In support of that executive order, CMS has published guidance titled “Reinforcement of EMTALA Obligations specific to Patients who are Pregnant or are Experiencing Pregnancy Loss.” Find that guidance here and the agency’s expanded explanation of that guidance in this memo to state survey agencies.  [...]

Federal Health Policy Update for Thursday, July 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, July 7.  Some of the language used below is taken directly from government documents. The Courts Hospitals may sue state Medicaid programs for failing to ensure that private insurers – such as Medicaid managed care plans – pay hospitals in a timely manner for the care they provide to their Medicaid patients, a federal appeals court has ruled.  See the court’s decision in this case. Centers for Medicare & Medicaid Services CMS has proposed a series of changes in the Medicare cost [...]

Hospital Readmissions Tied to Local Medical Resources?

Communities with more primary care doctors and more nursing home beds experience fewer avoidable hospital readmissions, according to a new study. At the same time, communities with more nurse practitioners and more home health agencies experience a high rate of hospital readmissions. In addition to the significance this may have for the welfare of the residents of individual communities, such a finding also may have implications for Medicare’s hospital readmissions reduction program, which penalizes hospitals that have “too many” readmissions for selected medical problems.  If the availability of certain community resources has a meaningful impact on readmissions it may be [...]

2022-07-07T13:34:05-04:00July 7, 2022|Medicare|

Transparency Comes to Health Insurer Payments

When the calendar turned to July, health insurers came under a new federal requirement that they post on web sites the price they pay to every provider with which they contract for every service they cover. The mandate, which traces its origins to the Affordable Care Act and was introduced in a 2019 executive order, was designed to enable consumers to compare what different insurers pay different providers for different services and possibly help them shop for more affordable services for themselves.  Doing so, however, will be a challenge for consumers at least at first because insurers will be posting [...]

2022-07-06T13:42:45-04:00July 6, 2022|Affordable Care Act, hospitals|
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