iqtsupport, Author at DeBrunner & Associates

Community Health Center Patients Often Have Housing Problems

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association. Among those problems: two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness. Some have homes that are not their own. Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions. Learn more about how housing challenges affect health and health care in the JAMA report “Prevalence of Housing [...]

iqtsupport2018-02-26T06:00:43-05:00February 26, 2018|Uncategorized|

Chronic Care Program Shows Early Encouraging Results

Medicare’s chronic care management program appears to be reducing the cost of caring for participants while improving their quality of life. The program, which pays physicians for non-face-to-face services they provided to coordinate care for their Medicare patients with at least two chronic medical conditions, was introduced in 2015. An analysis of its performance found that payments of up to $50 a month …improved patient satisfaction and adherence to recommended therapies, improved clinician efficiency, and decreased hospitalizations and emergency department (ED) visits. While Medicare paid roughly $52 million in chronic care management fees during the initial program period, the program [...]

iqtsupport2018-02-23T06:00:04-05:00February 23, 2018|Medicare|

GAO: CMS Needs to Do Better Job on Demonstration Evaluations

The federal government needs to do a better job of evaluating Medicaid demonstration programs, according to the U.S. Government Accountability Office. Demonstration programs, on which the federal government spends more than $300 billion a year, exempt states from selected federal Medicaid requirements and regulations so they can test new approaches to providing and paying for care for their Medicaid population. As part of waiving these requirements, the Centers for Medicare & Medicaid Services requires the states to perform or commission evaluations of the effectiveness of those new approaches. According to a new GAO study, however, those reports are not always [...]

iqtsupport2018-02-22T06:00:25-05:00February 22, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

Administration Slows Movement Toward Medicare Quality Payments

The Trump administration is slowing Medicare’s movement toward making greater use of quality in its payment system. The Obama administration’s goal of having 50 percent of Medicare payments made through a quality or alternative payment model by the end of 2018 now appears to be out of sight. Instead, the Centers for Medicare & Medicaid Services has partially canceled two bundled payment programs – one for joint replacement and another for cardiac rehabilitation programs – and announced that before introducing new programs it wants to take a closer look at the successes and failures of the alternative payment model programs [...]

iqtsupport2018-02-20T10:26:50-05:00February 20, 2018|Centers for Medicare & Medicaid Services, Medicare|

Senators Push IRS on Non-Profit Compliance

Two prominent senators have written to the Internal Revenue Service seeking information about what the agency is doing to ensure that non-profit hospitals comply with the requirements for providing sufficient community benefits to justify their tax-exempt status. Senators Orrin Hatch (R-UT), chairman of the Senate Finance Committee, and Chuck Grassley (R-IA), a senior member of that committee, have asked the IRS to provide their committee with specific information about how the IRS evaluates non-profit hospitals’ Form 990 Schedule H; about guidance the IRS provides regarding how hospitals define their communities and their communities’ needs; about the performance and outcome of [...]

iqtsupport2018-02-16T09:38:58-05:00February 16, 2018|Uncategorized|

Physician-Owned Hospitals Returning?

In testimony before the House Ways and Means Committee, new Health and Human Services Secretary Alex Azar indicated that he may be receptive to easing restrictions on physician-owned hospitals. The Affordable Care Act made it difficult for doctors either to launch new hospitals of their own or to expand physician-owned hospitals already in operation, and many existing physician-owned facilities stopped serving Medicare patients. In response to a question from a committee member, Azar expressed his interest in working to enable physician-owned hospitals to operate. Learn more from this Fierce Healthcare article.

iqtsupport2018-02-15T09:56:12-05:00February 15, 2018|Uncategorized|

Lowering Prescription Drug Costs

Shifting Medicare Part B drug coverage into Medicare Part D. Reducing Medicare Part D co-pays for generic drugs. Increasing the number of pharmacy benefit managers. Establishing expedited review for new versions of brand-name drugs. Tying U.S. drug prices to prices paid for the same drugs in other countries. Using U.S. trade policies to compel other countries to pay more for American pharmaceutical products. These are among the ideas presented in a new report by the White House Council of Economic Advisers detailing steps that might be taken to reduce prescription drug prices in the U.S. To learn more about these [...]

iqtsupport2018-02-12T10:45:34-05:00February 12, 2018|Medicare|

Medicaid Changes: More Than Just Work Requirements Coming?

While the green light for state applications to impose work requirements on their Medicaid recipients is receiving all of the attention, the Trump administration has issued guidance that appears to pave the way for other major changes in the Medicaid program as well. Specifically, the Centers for Medicare & Medicaid Services has issued guidance that will enable states to pursue section 1115 waivers to test different ways of serving Medicaid patients that are otherwise not permitted under federal Medicaid law, including: establishing time limits on how many months or years individuals may be enrolled in Medicaid; locking out for a [...]

iqtsupport2018-02-09T06:00:25-05:00February 9, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations|

A New Wave of Medicaid Expansion?

Spurred by the Trump administration’s invitation to states to apply for approval to make work requirements a part of their Medicaid program, a number of states that spurned the opportunity created for expansion under the Affordable Care Act may consider pursuing Medicaid expansion in the near future. Currently, some elected officials in Idaho, Kansas, North Carolina, Utah, Virginia, and Wyoming appear to be considering what they once considered unthinkable: making more of their residents eligible for Medicaid. For the most part, expansion talk is coming from moderate Republican legislators who believe a work requirement may help soften the staunch opposition [...]

iqtsupport2018-02-01T06:00:45-05:00February 1, 2018|Affordable Care Act, Medicaid|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met last week in Washington, D.C. to discuss a variety of Medicaid and Children’s Health Insurance Program issues. MACPAC, the non-partisan legislative branch agency that performs policy and data analysis and makes recommendations to Congress, the administration, and the states, addressed a number of issues during the meeting. Among them it discussed Medicaid managed long-term services and supports (MLTSS) and voted to recommend that states be given the opportunity to seek permission to make Medicaid beneficiary enrollment in managed care plans mandatory through revisions of their state plan amendment rather than by [...]

iqtsupport2018-01-30T06:00:58-05:00January 30, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid managed care|

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