iqtsupport, Author at DeBrunner & Associates

State to Experiment with Global Budgets for Rural Areas

The Commonwealth of Pennsylvania plans to launch an experiment in which participating health insurers will fund global budgets to care for residents served by selected rural hospitals. The program seeks to preserve access to care in rural parts of the state by stabilizing the financial health of struggling rural hospitals. According to a Pennsylvania Department of Health news release, The Rural Health Model is an alternative payment model, transitioning hospitals from a fee-for-service model to a global budget payment. Instead of hospitals getting paid when someone visits the hospital, they will receive a predictable amount of money. Payment for the [...]

iqtsupport2019-03-07T13:00:31-05:00March 7, 2019|Alternative payment models, hospitals, Pennsylvania|

Stark Changes Coming to Facilitate Value Care?

At a Washington, D.C. conference, Centers for Medicare & Medicaid Services Administrator Seema Verma announced that changes coming in Stark law requirements will enable Medicare to make better use of value-based purchasing in its reimbursement system. In addition to addressing cybersecurity and electronic health record system issues, changes in the anti-self-referral law will seek to facilitate better coordination of care for Medicare patients. Verma explained the underlying rationale for the anticipated changes, noting that …in a system where we’re transitioning and trying to pay for value, where the provider is ideally taking on some risk for outcomes and cost overruns, [...]

iqtsupport2019-03-07T06:00:54-05:00March 7, 2019|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, Medicare reimbursement policy|

Rural Nursing Homes Struggle With Challenges

Across rural parts of the country skilled nursing facilities are struggling, and growing numbers are faltering in the face of many problems. Among the challenges they face are: difficulty passing health and safety standards evolving health care policies that encourage people to remain in their homes instead of choosing to enter nursing homes growing proportions of patients covered by Medicaid the failure of Medicaid payments in many states to cover the cost of nursing home care These challenges are especially acute in rural areas. Today, many regions have enough skilled nursing beds, at least on paper, but they are not [...]

iqtsupport2019-03-06T06:00:27-05:00March 6, 2019|Medicaid, post-acute care|

800 Hospitals Face Medicare Penalties

800 hospitals will see their Medicare payments reduced one percent this year because they are among the 25 percent of hospitals in the U.S. with the highest rate of hospital-acquired conditions. Among the 800 hospitals are 110 that are being penalized for the fifth year in a row. Medicare’s hospital-acquired condition reduction program tracks a variety of medical problems, including infections, blood clots, sepsis, hip fractures, bedsores, and others. Every year, the 25 percent of eligible providers – the program excludes significant numbers of hospitals – are penalized even if their performance for hospital-acquired conditions is superior to the previous [...]

iqtsupport2019-03-05T06:00:59-05:00March 5, 2019|hospitals, Medicare, Medicare regulations|

Hospitals Show Mixed Results on Investments

Some hospitals are doing much better than others with their investments. According to a new report, several large health systems have recently reported major losses with their investments. On the other hand, a report late last year found that roughly half of hospitals’ net margins over the past two years has come from investment income. Learn more from the Becker’s Hospital Review article “Investment income made up almost 50% of hospitals' net margin in past 2 years.”

iqtsupport2019-03-04T06:00:01-05:00March 4, 2019|hospitals|

Grassley, Senate Finance to Resume Probe of Non-Profit Hospitals

The Senate Finance Committee will launch a review of non-profit hospitals and whether they are meeting the formal community benefit standards required to justify their tax-free status. This subject has long been of interest to committee chairman Chuck Grassley, who has returned as committee chair. He pursued the same question of the hospitals’ non-profit status and community benefit provide while leading the Senate Finance Committee from 2003 to 2007 and also as a member of the committee, although not its chair, in recent years. In a letter to the commissioner of the Internal Revenue Service, which is responsible for reviewing [...]

iqtsupport2019-03-01T06:00:44-05:00March 1, 2019|hospitals|

Nursing Home Study: More Medicaid Patients=Worse Care

Nursing homes that serve larger proportions of Medicaid patients have lower quality ratings, according to a new study from the American Health Care Association, a long-term-care provider trade group. The study also found that: For-profit nursing homes care for more Medicaid patients than non-profits. Rural nursing homes care for more Medicaid patients than urban facilities. Large facilities care for a higher proportion of Medicaid patients than smaller facilities. Learn more about the study and the theories behind some of these findings in the McKnight’s Long-Term Care News article “AHCA study: Facilities with higher Medicaid populations have poorer quality outcomes.” [...]

iqtsupport2019-02-28T13:00:01-05:00February 28, 2019|Medicaid, post-acute care|

OIG: Medicare Errs in Paying for Some Skilled Nursing Care

Medicare is erroneously paying for skilled nursing facility care for beneficiaries who did not spend three nights in an acute-care hospital, the U.S. Department of Health and Human Services’ Office of the Inspector General has concluded. Based on a limited sampling, the OIG estimates that Medicare spent $84 million on such ineligible services from 2013 through 2015. A new report from the OIG explains that We attribute the improper payments to the absence of a coordinated notification mechanism among the hospitals, beneficiaries, and SNFs to ensure compliance with the 3-day rule. We noted that hospitals did not always provide correct [...]

iqtsupport2019-02-28T06:00:33-05:00February 28, 2019|Medicare reimbursement policy|

Nursing Home Occupancy Down

Nursing home occupancy fell from 83.07 percent in 2013 to 80.24 percent at the end of 2017, according to a new report. The amount of time patients spend in nursing homes is falling as well. Declining occupancy and length of stay and shrinking reimbursement have led to nursing home closings and a six percent decline in cash on hand between 2013 to 2017. Learn more about some of the challenges facing skilled nursing facilities in the McKnight’s Long-Term Care News report “Dwindling reimbursement, occupancy numbers chipping away at skilled nursing margins, new analysis finds.”

iqtsupport2019-02-27T13:00:08-05:00February 27, 2019|post-acute care|

Surprise Balance Billing Emerges as Issue in DC

Lawmakers on both sides of the political aisle are expressing interest in addressing the problem of surprise balance billing: when insured individuals receive unexpected medical bills from providers for services for which they believe they are insured. Surprise balance bills have been a problem for years, with a number of proposals offered in the past to address the problem. Now, bipartisan support for a solution appears to be growing in Congress. In a new report, the journal Health Affairs describes the issue, outlines balance billing proposals offered in the recent past, and describes the challenges members of Congress now face [...]

iqtsupport2019-02-27T06:00:38-05:00February 27, 2019|Uncategorized|

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