iqtsupport, Author at DeBrunner & Associates

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week. Among the issues on the agenda of the independent agency that advises Congress on Medicare payment issues were: payment adequacy for physicians and other health professional services An alternative to the merit-based incentive payment system (MIPS) payment adequacy for hospital inpatient and outpatient services payment adequacy for ambulatory surgical center services payment adequacy and improving the equity of payments for skilled nursing facility services payment adequacy for inpatient rehabilitation services payment adequacy for long-term-care hospital services payment adequacy for home health services payment adequacy for outpatient dialysis services payment [...]

iqtsupport2017-12-13T06:00:25-05:00December 13, 2017|hospitals, Medicare, MedPAC|

Hospitals, Trade Groups Differ on Supervision Requirements

According to provider representatives and trade groups, the requirement that physicians supervise the administration of outpatient therapeutic services to Medicare patients in critical access and small rural hospitals is onerous and could limit patient access to such services. The people who run those hospitals don’t agree. That is the conclusion reached by the Medicare Payment Advisory Commission, which looked into the matter after Congress overturned a Centers for Medicare & Medicaid Services supervision requirement in the 21st Century Cures Act because, as MedPAC observed, CAH and rural hospital representatives…expressed concerns that, because they have difficulty recruiting physicians to practice in [...]

iqtsupport2017-12-12T06:00:08-05:00December 12, 2017|Medicare, Medicare regulations|

ED Myths Exposed

The uninsured do not use emergency rooms more than the insured. And the expansion of health insurance coverage increases rather than decreases ER use. So concludes the new Health Affairs study “The Uninsured Do Not Use the Emergency Department More – They Use Other Care Less.” Find the study here.

iqtsupport2017-12-11T06:00:12-05:00December 11, 2017|hospitals|

Fitch: Stable Outlook for Health Care in 2018

Despite a number of potential threats, Fitch Ratings predicts a stable financial environment for the health care industry in 2018. Fitch’s warns, though, of “outside disruptions” that could threaten that stability. Among those potential disruptions are tax reform legislation, government regulations, Amazon’s rumored entry into the industry, and advances in technology. The company predicts that ratings downgrades will exceed upgrades in the coming year. Learn more about Fitch’s predictions in this Healthcare Dive article.

iqtsupport2017-12-07T06:00:07-05:00December 7, 2017|Uncategorized|

CMS Publishes Quality Measures Under Consideration for 2018

The Centers for Medicare & Medicaid Services has published a list of quality measures it is considering implementing in Medicare quality programs in the coming year. The list consists of 32 proposed measures, down significantly from the nearly 100 it proposed last year. These measures are subject to comment by the National Quality Forum and stakeholders. Go here to see a commentary from CMS explaining what it hopes to accomplish and how it is pursuing those goals and go here to see a CMS document presenting the 32 proposed quality measures.

iqtsupport2017-12-06T06:00:01-05:00December 6, 2017|Medicare, Medicare regulations|

New Help With Addressing Low-Income Patients’ Social Services Needs?

One of the long-time barriers to states and hospitals addressing low-income patients’ social services needs and the social determinants of health has been a lack of resources for such assistance. Medicaid, in particular, has not been a financial participant in such efforts. But that may be changing. The new federal Medicaid managed care regulation, updated nearly two years ago, allows for the inclusion of some non-clinical services as covered Medicaid services and for funding for such services to be folded into Medicaid managed care plans’ capitation rates and medical loss ratios. The updated regulation also encourages greater coordination of care [...]

iqtsupport2017-12-04T06:00:13-05:00December 4, 2017|Medicaid|

The Battle Over 340B

Hospitals and other health care providers say it is an essential tool in ensuring access to care, and to prescription drugs, for their low-income patients. Pharmaceutical companies say it has expanded beyond its original purpose and is being used by hospitals to pad their profits. Members of Congress are divided: some are supportive and some are skeptical. The section 340B program that requires drug companies to provide discounts to selected hospitals and other providers that serve large numbers of low-income patients has been the subject of controversy in recent years. During that time, the administration has generally sided with hospitals [...]

iqtsupport2017-11-30T06:00:01-05:00November 30, 2017|Medicare, Medicare regulations|

Is Readmissions Reduction Program Hurting Some Patients?

A new study suggests that the decline in avoidable hospital readmissions of Medicare patients driven by the federal program’s hospital readmissions reduction program may be harming cardiac patients. According to a new study published in the journal JAMA Cardiology, while the readmissions reduction program has reduced readmissions among heart failure patients from 20 percent before the program was launched to 18.4 percent, the mortality rate among the same patients rose from 7.2 percent to 8.6 percent – 5400 more deaths a year. To learn more about the study, its results, why experts believe this may be happening, and information about [...]

iqtsupport2017-11-29T06:00:23-05:00November 29, 2017|Medicare|

Telehealth on the Upswing

A number of recent developments suggest that serving patients with the assistance of telehealth services will become more commonplace in the near future. The Medicare MACRA and MIPS payment programs will include new billing codes for telehealth services, according to regulations published earlier this month. Also earlier this month, the House passed legislation, The Vets Act (H.R. 2123), that would authorize the Veterans Administration to make greater use of telehealth. And when the U.S. Department of Health and Human Services’ Office of the Inspector General recently announced plans to audit Medicaid programs for telehealth payments, it cited among its reasons [...]

iqtsupport2017-11-28T06:00:17-05:00November 28, 2017|Medicaid, Medicare, Medicare regulations|

Socio-Economic Factors’ Role in Skilled Nursing Facility Finances

Skilled nursing facilities located in communities with higher-than-typical numbers of low-income and minority patients are under greater financial stress than comparable facilities located in other communities. Nursing homes that serve higher proportions of Medicaid patients the same challenge. And both of these conditions detract from the quality of care such facilities provide. These are the findings of a new study published in the journal Health Services Research. According to the study, Medicaid-dependent nursing homes have a 3.5 percentage point lower operating ratio. Those serving primarily racial minorities have a 2.64-point lower quality rating. A 1 percent increase in the neighborhood [...]

iqtsupport2017-11-21T06:00:22-05:00November 21, 2017|post-acute care|

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