iqtsupport, Author at DeBrunner & Associates

Hospitals Find Bundled Payment Savings Through Attention to Nursing Care

Hospitals participating in Medicare’s Comprehensive Care for Joint Replacement model and its Bundled Payments for Care Improvement program are finding the savings the program seeks in part through greater attention to the post-acute-care needs of their patients. As a new study has found: One principal strategy was to reduce SNF referrals, using risk-stratification tools, patient education, home care supports, and linkages with home health agencies to facilitate discharges to home. Another was to enhance integration with SNFs: fifteen hospitals or health systems in our sample had formed networks of preferred SNFs to exert influence over SNF quality and costs. Learn [...]

iqtsupport2018-09-06T06:00:22-04:00September 6, 2018|Medicare|

Ways and Means Releases Red Tape Report

The House Ways and Means Committee has released a report detailing its efforts to date to reduce red tape in the delivery of health care and to present steps it might take in the future to continue with that process. In the first stage of its red tape project, Ways and Means solicited stakeholder input and heard from nearly 300 stakeholder groups. Next, it hosted roundtable discussions with various groups to review the issues they raised. Now, following publication of its report, the committee plans to work in consultation with the administration to advance legislation to address some of the [...]

iqtsupport2018-09-05T06:00:30-04:00September 5, 2018|Uncategorized|

Next Generation ACO Nets Savings

Medicare’s Next Generation Accountable Care Organization model saved taxpayers $62 million in 2016, or 1.1 percent of the spending of the participating organizations, the Centers for Medicare & Medicaid Services has announced. The program also reduced hospitalizations 1.3 percent. In all, 18 organizations participated in the model program in 2016. Among them, four organizations accounted for more than half of the savings. In 2015, 45 organizations participated in the model and 51 are participating this year. Under the Next Generation ACO model, participants assume greater financial risk for their performance than under other Medicare models but also are eligible to [...]

iqtsupport2018-09-04T06:00:50-04:00September 4, 2018|Accountable Care Organization, ACO, Medicare|

CMS Reinforces Need for Budget Neutrality in Medicaid Waivers

States that seek federal waivers for permission to employ new approaches to serving their Medicaid population will have to pass more rigorous tests to ensure that those new approaches are budget-neutral, the Centers for Medicare & Medicaid Services has announced. In a detailed letter to state Medicaid directors, CMS outlines some of the current methodologies employed by states to demonstrate the budget neutrality of their waiver requests and details instances in which it will judge those methodologies differently in the future. A news release accompanying the letter explains that ….this letter marks the first time that CMS has formally outlined [...]

iqtsupport2018-08-31T06:00:11-04:00August 31, 2018|Medicaid|

Growing Number of Hospitals on the Critical List

Eight percent of American hospitals – 450 of them – are at risk of closing in the coming years and another 10 percent, or 600 hospitals, are considered “weak” according to a new analysis performed by Morgan Stanley. The signs of these problems include sinking margins, declining occupancy and revenue, and government and insurer policies that enable patients to receive certain services at facilities other than hospitals, as they did in the past. The largest concentrations of at-risk hospitals can be found in Texas, Oklahoma, Louisiana, Kansas, Tennessee, and Pennsylvania. Learn more about the Morgan Stanley analysis in this Bloomberg [...]

iqtsupport2018-08-29T06:00:43-04:00August 29, 2018|Uncategorized|

Large Number of Hospitals on the Critical List

Eight percent of American hospitals – 450 of them – are at risk of closing in the coming years and another 10 percent, or 600 hospitals, are considered “weak” according to a new analysis performed by Morgan Stanley. The signs of these problems include sinking margins, declining occupancy and revenue, and government and insurer policies that enable patients to receive certain services at facilities other than hospitals, as they did in the past. The largest concentrations of at-risk hospitals can be found in Texas, Oklahoma, Louisiana, Kansas, Tennessee, and Pennsylvania. Learn more about the Morgan Stanley analysis in this Bloomberg [...]

iqtsupport2018-08-29T06:00:35-04:00August 29, 2018|hospitals|

HHS Seeks Feedback on Anti-Kickback Challenges

The Office of the Inspector General of the U.S. Department of Health and Human Services has issued a request for information from health care stakeholders on how the federal government might modify current safe-harbor and anti-kickback laws and regulations in ways that might promote the provision of better health care at lower costs. The RFI explains that The Office of Inspector General (OIG) seeks to identify ways in which it might modify or add new safe harbors to the anti-kickback statute and exceptions to the beneficiary inducements civil monetary penalty (CMP) definition of “remuneration” in order to foster arrangements that [...]

iqtsupport2018-08-28T14:45:40-04:00August 28, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

Medicaid Expansion Helping Diabetics

The Affordable Care Act’s Medicaid expansion has led to a 40 percent increase in the number of prescriptions for diabetes medicine filled in the 30 states that expanded their Medicaid programs. Meanwhile, there was no change in the number of diabetes-related prescriptions filled in states that did not expand their Medicaid programs. This is considered important because it suggests that many low-income people who either could not afford their diabetes medicine or whose illness was undiagnosed are now being treated for the disease – a significant development because every diabetic who is treated for the condition represents a cost savings [...]

iqtsupport2018-08-08T06:00:12-04:00August 8, 2018|Affordable Care Act, Medicaid|

Medicare Announces FY 2019 Inpatient Payments

The Centers for Medicare & Medicaid Services has released its FY 2019 payment schedule for Medicare inpatient services. Highlights of the FY 2019 inpatient prospective payment system regulation include: A 1.75 percent increase in fee-for-service rates. A $1.5 billion increase in Medicare disproportionate share hospital payments (Medicare DSH). Major reductions of the quality measures hospitals must report for Medicare’s inpatient quality reporting and value-based purchasing programs. A requirement that hospitals post their standard charges on the internet. Learn about these and other aspects of Medicare’s FY 2019 inpatient prospective payment system regulation by seeing this Medicare fact sheet or going [...]

iqtsupport2018-08-06T06:00:07-04:00August 6, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations|

Battle Over Medicaid Work Requirements Not Over

The Secretary of Health and Human Services is not accepting a recent federal court ruling as the final word on Medicaid work requirements. Although the court ruled against a federally approved plan to permit the state of Kentucky to implement a work requirement for some able-bodied Medicaid recipients, HHS Secretary Alex Azar insists that his department will continue to support work requirements for Medicaid beneficiaries. Azar told a Heritage Foundation audience that We suffered one blow in district court in litigation, but we are undeterred. We’re proceeding forward…We’re fully committed to work requirements and community participation in the Medicaid program…we [...]

iqtsupport2018-08-01T06:00:24-04:00August 1, 2018|Medicaid|

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