iqtsupport, Author at DeBrunner & Associates

Verdict: Medicaid Expansion Improved Care and Access

A new review of studies published since the Affordable Care Act’s Medicaid expansion has concluded that expansion improved care, access to care, and coverage in states that expanded their Medicaid programs. Among the improvements cited by studies are: greater use of primary care more preventive health visits more behavioral health care shorter hospital stays fewer avoidable hospital admissions reduced access problems reduced reliance on hospital ERs as a primary source of care improved monitoring and compliance rates for patients with diabetes and hypertension higher rates of screening for prostate cancer and Pap smears In addition, hospitals provided less uncompensated care [...]

iqtsupport2018-06-11T06:00:05-04:00June 11, 2018|Affordable Care Act, Medicaid|

CMS Reports on Medicaid Long-Term Care Spending

The Centers for Medicare & Medicaid Services has issued a report on FY 2016 spending for Medicaid-covered long-term services and supports. The highlights of the $167 billion in state and federal spending include: Home and community-based services have accounted for almost all Medicaid long-term services and supports growth in recent years. Home and community-based services spending increased 10 percent in FY 2016, greater than the five percent average annual growth from FY 2011 through 2015. Institutional spending remained close to the FY 2010 amount. Institutional service spending decreased two percent in FY 2016 following an average annual increase of [...]

iqtsupport2018-06-08T06:00:16-04:00June 8, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid long-term services and supports|

CMS Introduces Medicaid “Scorecard”

The Centers for Medicare & Medicaid Services has unveiled a “scorecard” through which interested parties will be able to monitor outcomes for state Medicaid programs, state CHIP programs, and CMS itself while also comparing the performance of states to one another. The purpose of the scorecard, according to CMS, is “to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes.” CMS also explained that The first version of the Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal [...]

iqtsupport2018-06-07T06:00:29-04:00June 7, 2018|Centers for Medicare & Medicaid Services, Medicaid|

Review: Telehealth Shows Mixed Results

A federal review of the use of telehealth services suggests that such services may be appear useful in helping to improve care and reduce costs under certain conditions but are less useful in others. According to a draft currently under review by the Agency for Health Care Research and Quality, Remote intensive care unit (ICU) consultations likely reduce ICU mortality and ICU length of stay (LOS); specialty telehealth consultations likely reduce the time patients spend in the emergency department; and remote consultations for outpatient care likely improve access and a range of clinical outcomes (moderate strength of evidence in favor [...]

iqtsupport2018-06-06T06:00:29-04:00June 6, 2018|Uncategorized|

Study Raises Questions About Progress Toward Reducing Readmissions

A new study suggests that the reduction in hospital readmissions of recent years may not be as meaningful a reflection of improved quality of care as some observers believe. According to a new study published in the New England Journal of Medicine, at the same time that hospitals have reduced their readmissions of Medicare patients in response to penalties imposed through Medicare’s hospital readmissions reduction program, the rate of readmission of patients who are hospitalized for observation stays after visiting the emergency room has increased 35 percent. This increase in readmissions for observation stay patients comes at a time, moreover, [...]

iqtsupport2018-06-05T10:03:22-04:00June 5, 2018|Medicare|

S&P: 340B Cuts Will Hurt

Payment cuts in the 340B prescription drug program will most likely hurt hospital financial performance, and among those most likely to be hurt are DSH hospitals, small hospitals, and rural hospitals. These are among the conclusions in a report recently issued by S&P Global Ratings. The report concludes that …the impact of the cuts to the 340B Drug Pricing Program on not-for-profit hospitals that rely on 340B drug savings will likely weaken their operating performance at a time of already tightening margins. Effective the beginning of 2018, the Centers for Medicare & Medicaid Services cut the 340B program 16 percent, [...]

iqtsupport2018-06-04T06:00:44-04:00June 4, 2018|340b|

Hospitals, Others Oppose Easing Medicaid Access Requirements

Hospital groups and other health care interest organizations have expressed strong opposition to a Centers for Medicare & Medicaid Services proposal to ease requirements that states ensure adequate access to care for their Medicaid population. Under current federal Medicaid law, states must periodically review their Medicaid provider networks to ensure that Medicaid recipients have adequate access to care. Under a March CMS proposal, that requirement would exempt states from performing such reviews if at least 85 percent of their Medicaid population is enrolled in a managed care plan and similarly exempt them from reviewing the impact on their provider networks [...]

iqtsupport2018-06-01T06:00:07-04:00June 1, 2018|Medicaid, Medicaid managed care, Medicaid regulations|

Medicare Model Program Improved Care But Didn’t Lower Costs

A federal program that tested a new approach to the delivery of Medicare services to high-risk patients delivered on its promise to improve the quality of care for patients but did not reduce the cost of caring for those patients. The Centers for Medicare & Medicaid Services’ Comprehensive Primary Care Initiative improved access to care for patients in more than 500 participating medical practices and reduced their ER visits two percent but did not reduce Medicare’s cost for caring for these patients. After several years in effect the program, which features enhanced care management for high-risk patients, improved coordination of [...]

iqtsupport2018-05-30T06:00:04-04:00May 30, 2018|Medicare|

The 340B Issue Explained

The section 340B prescription drug discount program has grown increasingly controversial in recent years. The program, established in the 1990s to help hospitals with the cost of the prescription drugs they provide to low-income patients on an outpatient basis, has grown considerably since its inception. Pharmaceutical companies argue that it is too large, that it contributes to the growing cost of prescription drugs, and that hospitals are not using the savings they reap from the program to serve more low-income patients, as was envisioned when Congress created the program. Eligible providers, on the other hand, note that much of the [...]

iqtsupport2018-05-16T06:00:51-04:00May 16, 2018|340b|

Helping Safety-Net Hospitals Help Their Patients

A new report published on the Health Affairs Blog describes the continuing challenges safety-net hospitals face and offers suggestions for helping them meet those challenges. The challenges, according to the report, are the virtual elimination of the Affordable Care Act’s individual health insurance mandate; the continued decline in the amount of Medicare disproportionate share hospital money (Medicare DSH) provided to safety-net hospitals; and hospital closures that shift more of the burden for caring for uninsured patients onto a smaller pool of safety-net hospitals. The result is under-served patients and new financial risks for the hospitals that remain after some safety-net [...]

iqtsupport2018-05-15T06:00:29-04:00May 15, 2018|Affordable Care Act, hospitals, Medicare disproportionate share, Medicare DSH|

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