iqtsupport, Author at DeBrunner & Associates

Pressure Off 340B?

Two key House subcommittees will not hold hearings on the controversial 340B prescription drug discount program in the near future. The chairs of the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee and its Health Committee have both suggested that House Democrats understand the importance and value of the 340B program and see other health care issues as greater priorities. This marks a serious departure from the last session of Congress, which saw a number of hearings on the 340B program and doubts cast about the program’s objectives and future. Learn more from the Lexology article “340B Program Gets [...]

iqtsupport2019-04-03T06:00:55-04:00April 3, 2019|340b|

Bill Would Enable Foreign-Born Docs to Work in Underserved U.S. Areas

More foreign-born, U.S.-trained doctors would be permitted to remain in the U.S. if they practice in medically underserved areas under a bill unveiled last week in Congress. Introduced with bipartisan support, the legislation would extend for two years the current “Conrad 30” program that allocates 30 slots to each state so foreign-born doctors can work in medically underserved areas under J-1 visas. The program, which already exists but will soon expire, permits such physicians to remain in the U.S. for three years after their training ends to work in underserved areas. The legislation also would establish criteria under which more [...]

iqtsupport2019-04-02T06:00:17-04:00April 2, 2019|Uncategorized|

Prospects Mixed for Non-Profit Hospitals in 2019

There’s good news and bad news for non-profit hospitals in 2019, according to Fitch Ratings, the bond-rating company. The good news: For many, major IT investments have been completed. Many have adjusted to the reality of falling inpatient volume. Many that saw reduced margins as a result of launching, purchasing, or participating in provider-sponsored plans to compete in health exchanges have scaled back those efforts. The bad: profits and margins may continue to decline – but those declines will not be as steep as they have been in recent years. Reimbursement may be weaker, too. Learn more from the Fierce [...]

iqtsupport2019-04-01T10:17:11-04:00April 1, 2019|hospitals|

ACA Repeal Would Drive Up Uninsured, Uncompensated Care

At the same time that the Trump administration announced that it has asked a federal court to repeal the entire Affordable Care Act, the Urban Institute has published a report detailing the potential impact of the health care reform law’s repeal. According to the Urban Institute report, repealing the entire Affordable Care Act would add almost 20 million Americans to the ranks of the uninsured. Medicaid and CHIP enrollment would fall by 15.4 million people and millions of others would lose the tax credits they used to purchase insurance. Some would purchase insurance with limited benefits and individual plan premiums [...]

iqtsupport2019-03-29T06:00:00-04:00March 29, 2019|Affordable Care Act, health care reform, hospitals, Medicaid|

Feds Seek More EHR in Post-Acute-Care Settings

Electronic health records may find their way into more post-acute-care settings as a result of a request for information published by the Centers for Medicare & Medicaid Services. In the RFI, CMS notes that EHR adoption has been slow in the post-acute sector and asks stakeholders what it can do to accelerate the adoption of technology designed to facilitate communication among caregivers. While EHR adoption has occurred in other areas, its use is less common in the post-acute sector, and even when used, it is used more for record-keeping than for communication among providers. EHR use and interoperability among acute-care [...]

iqtsupport2019-03-27T15:17:31-04:00March 27, 2019|Uncategorized|

A New Trend: Tying Insurance Payments to Medicare Rates?

There may be a growing movement to tie some hospital payments directly to Medicare rates. Montana started doing it two years ago, linking payments for hospital services provided to state employees to Medicare rates. Oregon will start a similar program this fall. And now, North Carolina is laying plans for a similar approach while Delaware is considering doing so. Montana is paying an average of 234 percent of Medicare hospital rates. Oregon will pay 200 percent of Medicare rates. North Carolina is talking about paying Medicare rates plus 82 percent, with extra money for rural hospitals. Such an approach could [...]

iqtsupport2019-03-25T06:00:16-04:00March 25, 2019|Uncategorized|

Mixed Verdict: Home Health Leads to More Readmissions But Lower Costs

Readmission rates are greater for patients discharged from hospitals to home health care than they are for those discharged to skilled nursing facilities but home health services cost so much less than nursing homes that home health saves money even with the higher numbers of hospital readmissions. This is one of the major findings of a new study comparing differences in outcomes for patients who are admitted to skilled nursing facilities upon discharge from the hospital to those for patients who go direct home and receive home health services. The study also found no meaningful differences in patient mortality or [...]

iqtsupport2019-03-22T06:00:57-04:00March 22, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy|

HHS Chief Derides Medicare Wage Index System

U.S. Department of Health and Human Services Secretary Alex Azar criticized the current Medicare area wage index system during a hearing of the Senate Finance Committee last week. Reminding senators that he told them last year that they need to revise the system and warning that HHS’s ability to change it is limited without legislation, Azar referred to the system as an “absurdity” as individual senators pointed out what they view to be inequities in the system that hurt hospitals in their own states. Medicare’s area wage index system adjusts Medicare payments to hospitals based on geographic differences in the [...]

iqtsupport2019-03-21T06:00:01-04:00March 21, 2019|Medicare, Medicare regulations|

MACPAC Makes DSH, UPL Recommendations

Changes could come in Medicaid DSH and UPL payments if new MACPAC recommendations are adopted. Last week the Medicaid and CHIP Payment and Access Commission released its annual report to Congress, with most of the report focusing on its analysis and recommendations for policy updates involving Medicaid disproportionate share hospital payments (Medicaid DSH) and Medicaid upper payment limit payments (UPL payments). With Affordable Care Act-mandated cuts in Medicaid DSH payments scheduled to start in FY 2020 – this coming October – MACPAC recommended that these cuts be reduced and phased in over a longer period of time “…to give states [...]

iqtsupport2019-03-20T13:00:48-04:00March 20, 2019|hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid upper-payment limit|

HHS Talking to States About Medicaid Block Grants

In the absence of legislation to turn Medicaid into a block grant program, the U.S. Department of Health and Human Services is talking to some states about granting waivers that permit them – voluntarily – to turn their individual Medicaid programs into block grants. HHS Secretary Alex Azar acknowledged this last week during a hearing of the Senate Finance Committee. He did not disclose which states, or how many, with which HHS has had such discussions and he also noted that his staff is talking to state officials about waivers to permit them to adopt Medicaid per capita spending limits. [...]

iqtsupport2019-03-20T06:00:51-04:00March 20, 2019|Medicaid|

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