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Outcomes Strong at Academic Medical Centers

Patients served at academic medical centers have a better chance of surviving the health problems that brought them to those facilities. Or so concludes a new study published in the journal Health Affairs. According to the study, We examined more than 11.8 million hospitalizations in the period 2012–14 for Medicare beneficiaries ages sixty-five and older and found that, after adjustment for patient and hospital characteristics, high-severity patients had 7 percent lower odds, medium-severity patients had 13 percent lower odds, and low-severity patients had 17 percent lower odds of thirty-day mortality when treated at an academic medical center for common medical conditions, compared to similar [...]

2018-07-06T06:00:14-04:00July 6, 2018|hospitals|

GAO Recommends Changes in Oversight of 340B Program

The federal Government Accountability Office is recommending that the Department of Health and Human Services improve its oversight of the 340B prescription drug discount program. That program was created by Congress to help safety-net providers obtain discounts on prescription drugs they dispense to low-income patients on an outpatient basis.  Those discounts are provided by pharmaceutical companies and not paid for with taxpayer money. The 340B program has been controversial in recent years, and in response to a request from Congress for the GAO to look into the contract pharmacies that operate the 340B programs for many safety-net providers, the GAO [...]

2018-07-02T06:00:12-04:00July 2, 2018|340b|

With Eye on Value-Based Care, CMS Eyes Stark Law Change

Interested in addressing legal obstacles that prevent providers from participating in innovative payment models, the Centers for Medicare & Medicaid Services has put out a call for stakeholders to address challenges raised by the so-called Stark law that makes it difficult for physicians to participate in such models. In a news release accompanying CMS’s publication of its request for information, the agency notes that Over the past year, CMS has engaged with the provider community in a discussion about regulatory burden issues. This included publishing a Request for Information (RFI) soliciting comments about areas of high regulatory burden. One of [...]

Proposed Federal Reorganization Could Affect Health Care

Aspects of a proposed reorganization of the federal government could affect the agencies that administer key health care programs. In its 132-page Delivering Government Solutions in the 21st Century:  Reform Plan and Reorganization Recommendations proposal, the White House calls for consolidating many social safety-net programs in a new Department of Health and Public Welfare.  This department would retain responsibility for Medicare and Medicaid but also would assume responsibility for some food aid programs, including food stamps (now the Supplemental Food Assistance Program, or SNAP). In addition, the proposal would: consolidate all health research programs in the National Institutes of Health, [...]

2018-06-27T06:00:39-04:00June 27, 2018|Medicaid, Medicare|

CMS Unveils Medicaid “Scorecard”

The Centers for Medicare & Medicaid Services had introduced a new “Medicaid scorecard” that the agency says it hopes will “…increase public transparency about the programs’ administration and outcomes.” The scorecard, now posted on the Medicaid web site, presents information and data from the federal government, and reported voluntarily by the states, in three areas:  state health system performance, state administrative accountability, and federal administrative accountability. The scorecard currently offers information on selected health and program indicators.  Visitors can see comparative data between states and also extensive information about individual state Medicaid programs, including eligibility criteria, enrollment, quality performance, and [...]

2018-06-26T06:00:20-04:00June 26, 2018|Medicaid|

Hospital Government Payment Losses Could Reach $218 Billion by 2028

A recent study concluded that hospitals can expect to lose about $218 billion in federal Medicare and Medicaid payments between 2010, when the latest round of major cuts began, and 2028. Among those cuts cited in the study, which was commissioned by the American Hospital Association and the Federation of American Hospitals, are: $79 billion for DRG documentation and coding adjustments $73 billion for Medicare sequestration $26 billion for Medicaid disproportionate share payments (Medicaid DSH) $11 billion in cuts associated with the American Taxpayer Relief Act of 2012 Other cuts came, or will be coming, through regulatory changes, the introduction [...]

Uninsured Rise Could Hurt Non-Profit Hospitals

The recent growth in the number of uninsured Americans could be especially harmful to non-profit hospitals and health systems, according to S&P Global Ratings. As reported by Healthcare Dive, S&P believes that because non-profit hospitals serve larger proportions of uninsured patients, they are more vulnerable to increases in the number of uninsured people.  Healthcare Dive also notes that In particular, S&P warns of a credit negative for nonprofits as patients who started in a care plan with health insurance seek to continue treatment without it.  Many hospitals already are struggling as volumes and reimbursement decline and more care shifts to [...]

2018-06-22T06:00:43-04:00June 22, 2018|hospitals|

MedPAC Issues 2018 Report to Congress

The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress. Among the findings included in the report by the Medicare Payment Advisory Commission are: Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays. Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted. MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities. MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for [...]

ACOs Moving Into Medicaid

Accountable care organizations, one of the centerpieces of recent Medicare efforts to test new ways to deliver care more effectively and at less cost, are finding their way into state Medicaid programs as well. Today, a dozen states employ Medicaid ACOs and another ten are planning to do so. Learn more about Medicaid ACOs, and how one state (Minnesota), in particular, is using them, in this Kaiser Health News report.

2018-06-19T06:00:58-04:00June 19, 2018|Accountable Care Organization, ACO, Medicaid|

Amid Budget Woes, States May Look to Medicaid for Savings

Budget challenges may lead some states to seek changes in their Medicaid programs aimed at saving money. Or so reports Fitch Ratings, the bond rating company. According to Fitch, health care was the biggest driver in rising state spending between 2005 and 2015 and the portion of state spending on health and social services will increase from 30.7 percent in 2015 to 38.3 percent in 2025. Among the measures states will turn to in an effort to manage rising health care costs, according to Fitch, are Medicaid work requirements, reductions in Medicaid retroactive coverage, new Medicaid premiums, and lifetime limits [...]

2018-06-18T06:00:04-04:00June 18, 2018|Medicaid|
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