iqtsupport, Author at DeBrunner & Associates

Feds Open Door for Exemptions from Medicaid IMD Exclusion

New federal guidelines will make it easier for state Medicaid programs to cover mental health services provided in institutions for mental diseases (IMD). For years, Medicaid regulations greatly limited the ability of states to pay for care – generally, care related to substance abuse disorder treatment – provided in IMDs; this was generally known as the IMD exclusion. The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, which was passed in 2018, opened the door for more exceptions to these limits, and last week, [...]

iqtsupport2019-11-13T06:00:36-05:00November 13, 2019|Centers for Medicare & Medicaid Services, Medicaid|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s November agenda were: congressional request on health care provider consolidation increasing the supply of primary care physicians redesigning the Medicare Advantage quality bonus program reforming the benchmarks in the Medicare Advantage payment system considerations for plans serving low-income beneficiaries in the restructuring of Medicare Part D post-acute care spending under the Medicare Shared Savings Program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on [...]

iqtsupport2019-11-12T06:00:16-05:00November 12, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

MACPAC Looks at Medicaid DSH

At a time when cuts in Medicaid disproportionate share hospital payments (Medicaid DSH) are still scheduled for the current fiscal year and some in Congress are calling for a new approach to allotting DSH funds among the states, the Medicaid and CHIP Payment and Access Commission has released its annual analysis of Medicaid DSH allotments to the states. The report includes: data about changes in the uninsured rate demographic information about the uninsured information about the cost of hospital uncompensated care perspectives on hospital Medicaid shortfalls a comparison of hospital uncompensated care costs when calculated using different methodologies data about [...]

iqtsupport2019-11-08T06:00:27-05:00November 8, 2019|hospitals, MACPAC, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Commission devoted its Thursday morning discussion to integration of care for beneficiaries who are dually eligible for Medicaid and Medicare. Panelists Amber Christ, directing attorney at Justice in Aging; Griffin Myers, chief medical officer at Oak Street Health; and Michael Monson, senior vice president for Medicaid and complex care at Centene, presented beneficiary, provider, and health plan perspectives and a question and answer session followed. After lunch, MACPAC staff briefed the Commission on [...]

iqtsupport2019-11-07T06:00:47-05:00November 7, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Medicaid Expansion Brings Improvements to Expansion States

States that expanded their Medicaid programs under the Affordable Care Act have experienced fewer hospital admissions, shorter lengths of stays in the hospital, and lower hospital costs, according to a new Health Affairs study. Specifically, they experienced: a 3.1 percent decline in inpatient days a 3.5 percent decrease in discharges for conditions considered “ambulatory care-sensitive,” such as diabetes, chronic respiratory problems, and pneumonia a reduction of nearly three percent in hospital costs. Learn more about how Medicaid expansion has improved the health of the population in states that expanded their Medicaid programs in the Health Affairs study “Medicaid Expansion Associated [...]

iqtsupport2019-11-06T06:00:39-05:00November 6, 2019|Affordable Care Act, Medicaid|

MACPAC Looks at Medicaid Substance Abuse Treatment

The treatment of substance abuse problems with medication within the Medicaid population is the subject of a new report by the Medicaid and CHIP Payment and Access Commission. As required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, which was enacted last year, MACPAC has prepared a report on how selected states administer and regulate the use of medications used to treat opioid and alcohol use disorders. Among its findings: The frequency with which providers are prescribing medication to treat opioid and alcohol use disorders has exploded in recent years. States are [...]

iqtsupport2019-11-05T06:00:24-05:00November 5, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission|

Safety-Net Hospitals Gird for Loss of Medicaid DSH Money

Safety-net hospitals and others will lose a significant portion of their Medicaid disproportionate share (Medicaid DSH) payments on November 22 unless Congress delays implementation of the cut in those payments that was mandated by the Affordable Care Act. And hospitals that receive these payments are now preparing for the worst. The Medicaid DSH cut was included in the 2010 health care reform law in anticipation of a great reduction in the number of uninsured people leaving hospitals providing much less uncompensated care and therefore not in need of as much DSH money. The law’s reach has not proven to be [...]

iqtsupport2019-11-04T06:00:14-05:00November 4, 2019|Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

High-Deductible Plans Losing Luster Amid Low Unemployment

The competition for employees is leading more businesses to offer more generous health insurance plans in addition to high-deductible plans. As health insurance premiums rose in recent years, more and more companies were offering their employees more high-deductible insurance options to help keep down the cost of premiums. Now, however, with some workers clamoring for more conventional plans and businesses finding themselves in competition for workers at a time of low unemployment, more businesses are offering those conventional plans to their workers. 2020, in fact, will mark the third consecutive year during which the percentage of companies offering only high-deductible [...]

iqtsupport2019-11-01T06:00:26-04:00November 1, 2019|Uncategorized|

Azar: More Value-Based Care Coming

Medicare may add more value-based care initiatives and alternative payment models to those it already operates, Health and Human Services Secretary Alex Azar suggested at a recent event in Washington, D.C. During his remarks, Azar spoke about population health benefits, global budgeting for Medicare patients, more primary care programs, and new models that address kidney care and opioid use and hinted at future efforts that address social determinants of health. Learn more about Azar’s remarks about Medicare value-based purchasing and alternative payment models and other current federal health policy matters in the Healthcare Dive article “HHS chief keeps focus on [...]

iqtsupport2019-10-31T13:00:29-04:00October 31, 2019|Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy|

Verma Hints at More Medicaid Changes, Deregulation

Stay tuned for more Medicaid changes, Centers for Medicare & Medicaid Services administrator Seema Verma told a Las Vegas health care gathering last week. CMS, she told her audience, will …soon outline new opportunities for states to flip the Medicaid paradigm and free themselves from federal micromanagement. While Verma offered few details, one idea clearly emerged: there will be more deregulation. She insisted, for example, that Medicaid work requirements are not dead. While such requirements have run into trouble in the courts in recent months, she explained that CMS is developing new implementation guidelines to address some of the challenges [...]

iqtsupport2019-10-31T06:00:04-04:00October 31, 2019|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

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