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Medicaid Expansion Helps Save Hospitals

Hospitals in states that took advantage of the Affordable Care Act to expand their Medicaid programs are six times less likely to close than hospitals in non-expansion states. And the impact of Medicaid expansion is even more beneficial for hospitals that serve rural communities. These are among the new findings in a new study that examines the effect of Medicaid expansion on hospital finances and hospital closures.  Among those findings, We found that the ACA’s Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of [...]

2018-01-10T06:00:57-05:00January 10, 2018|Affordable Care Act, hospitals, Medicaid|

Report Looks at Work Requirements

As a growing number of states consider implementing work requirements as a condition for Medicaid eligibility, the Urban Institute has released a report that describes work requirements in various government cash assistance, nutrition assistance, and housing assistance programs and considers the degree to which those requirements have achieved their policy objectives. The report also describes the applications that eight states have submitted to the federal government seeking permission to introduce a work requirement in their Medicaid programs. Go here to see the Urban Institute report Work Requirements in Social Safety Net Programs: A Status Report of Work Requirements in TANF, [...]

2018-01-09T06:00:48-05:00January 9, 2018|Medicaid|

The Telehealth Trend

Patients, insurers (including government), and providers are all looking toward telehealth as a means of enhancing access to care and improving the health of people.  In recognition of this trend, the web site Healthcare Finance News has published a series of articles looking at telehealth: Growing demand for telemedicine fueling multibillion dollar market growth Telemedicine can lower costs for health systems by $24 a patient, study finds CMS to waive restrictions to reimburse for telemedicine in the joint replacement payment model Almost all large employers plan to offer telehealth in 2018, but will employees use it? Why telehealth is fueling [...]

2018-01-08T06:00:05-05:00January 8, 2018|Uncategorized|

Medicare Penalizes Hospitals for Avoidable Injuries, Illnesses

Medicare is reducing payments to 751 hospitals because of the high rate at which their patients have suffered avoidable injuries and illnesses while in the hospital. The penalties come under Medicare’s Hospital-Acquired Condition Reduction Program, which was established by the Affordable Care Act. Among the penalized hospitals, more than half were penalized last year as well 115 are academic medical centers – about one-third of all such facilities more than one-third of all safety-net hospitals were penalized Learn more about the program, the penalties, and why the penalties were assessed in this Kaiser Health News report.

2017-12-26T06:00:25-05:00December 26, 2017|Affordable Care Act, Medicaid regulations|

Medicaid Directors Meet

The National Association of Medicaid Directors held its fall conference recently outside Washington, D.C. This is an important event at which policy-makers and policy experts meet to discuss Medicaid programs, trends, challenges, and opportunities. Many of the materials used during that conference are now publicly available, including video clips from speeches by CMS Administrator Seema Verma and others and presentations on a number of subjects, including: delivering care across rural and frontier America Medicaid’s role in supporting community engagement and economic mobility busting the silos of physical and behavioral health care alternative payment models and addressing the social determinants of [...]

2017-12-21T06:00:09-05:00December 21, 2017|Medicaid|

MACPAC Meets

The non-partisan legislative branch agency that advises Congress, the administration, and the states on Medicaid and CHIP-related issues met recently in Washington, D.C. The following is the Medicaid and CHIP Payment and Access Commission’s own summary of its meeting. The December 2017 meeting of the Medicaid and CHIP Payment and Access Commission began with a brief update on the State Children’s Health Insurance Program (CHIP). Although federal funding for the CHIP expired at the end of September, legislation to renew funding was still pending in Congress. The Commission then heard from a panel discussing state tools to manage drug utilization [...]

2017-12-20T06:00:38-05:00December 20, 2017|Medicaid|

Reduced Hospitalizations and Improved Care for High-Risk Patients Not Driving ACO Savings

Medicare savings reported in the early years of the Medicare Shared Savings Program are not coming from reduced hospitalizations of high-risk Medicare patients or even through better coordination of care for those patients. Instead, Medicare accountable care organization savings are coming mostly from better and more coordinated care for low-risks Medicare ACO participants. These surprising findings are reported in the article “Medicare ACO Program Savings Not Tied To Preventable Hospitalizations Or Concentrated Among High-Risk Patients,” which can be found in the December 2017 edition of the journal Health Affairs.  Find a link to that article here.

Medicaid Discovery: More Services Can Reduce Costs

States that invest additional money addressing the social service needs of their highest-cost Medicaid patients are finding that the savings they gain from doing so exceed the cost of providing the social services. Often, by as much as two dollars of savings for every one dollar spent. With relatively small numbers of Medicaid patients consuming a significant portion of state Medicaid resources, providing additional social service assistance to such individuals can both improve their health and save money for the states according to a new report from the National Governors Association.  Most of these patients suffer from multiple medical problems, [...]

2017-12-18T06:00:07-05:00December 18, 2017|Medicaid|

Examining How Medicare Addresses Primary Care

As the country continues to struggle with a reported shortage of primary care physicians, Medicare, the country’s leading consumer of primary care services, continues to experiment with how best to pay for primary care and address the disparities in compensation between primary care doctors and specialists that has led to this shortage. In general, Medicare takes two approaches:  introduce new billing codes that create incentives for primary care physicians to engage in – and get paid for – practices Medicare seeks or establish demonstration programs that facilitate the introduction of incentives for engaging in promising approaches to primary care delivery. [...]

2017-12-15T06:00:05-05:00December 15, 2017|Medicare|

House to Set Sights on Medicare, Medicaid Cuts in 2018

The House of Representatives will pursue entitlement spending cuts next year, House Speaker Paul Ryan recently explained on a radio program. That means Medicare, Medicaid, and possibly even Social Security. Ryan said that We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking. Learn more about Ryan’s remarks, the administration’s priorities, and what other members of Congress are saying [...]

2017-12-14T06:00:11-05:00December 14, 2017|Medicaid, Medicare, Medicare cuts|
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