iqtsupport, Author at DeBrunner & Associates

Cures Law Addresses Shortcomings in Readmissions Program

The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The Cures Act changes this by instructing HHS to set different [...]

iqtsupport2017-02-13T06:00:15-05:00February 13, 2017|Medicare regulations|

Budget Reconciliation Explained

Congress may use the federal budget reconciliation process to repeal some aspects of the Affordable Care Act. But what is the budget reconciliation process and how does it work? Kaiser Health News has created a brief video, with an accompanying transcript, that explains. Find that video here.

iqtsupport2017-02-10T09:07:01-05:00February 10, 2017|Affordable Care Act|

A New Approach to Treating the Underserved

Last month Congress passed the Expanding Capacity for Health Outcomes Act. The new law calls for the U.S. Department of Health and Human services to study a New Mexico project that employs distance learning to enhance the ability of the medical community to serve medically underserved areas. Launched by the University of New Mexico in 2003, Project ECHO takes advantage of telehealth techniques to employ medical specialists who consult via videoconference with primary care providers. This approach can be employed to help patients in rural and underserved rural areas and to assist those with limited mobility who have difficulty traveling [...]

iqtsupport2017-02-07T06:00:34-05:00February 7, 2017|Uncategorized|

Long-Awaited 340B Guidance Withdrawn

The long-awaited “guidance” that was expected to bring potentially major changes to the federal section 340B prescription drug discount program has been withdrawn by the Department of Health and Human Services’ Health Resources and Services Administration. The final guidance, based on proposed guidance released in mid-2015, was expected to redefine the patients, providers, and prescription drugs eligible to participate in the 340B program. The document was thought to be in the final stages of review by the Office of Management and Budget. Learn more about the proposed guidance, what it was expected to address, who is relieved and who is [...]

iqtsupport2017-02-06T06:00:56-05:00February 6, 2017|Uncategorized|

MACPAC Concerned About Prospect of Medicaid Block Grants

Members of the non-partisan legislative agency that advises Congress on Medicaid and CHIP issues expressed concern at their most recent meeting about the possibility of the federal government turning Medicaid into a block grant program. At their meeting in Washington, D.C. last week, members of the Medicaid and CHIP Payment and Access Commission discussed the steps they would need to take to advise policy-makers about the issues they would need to address in making such a major policy change and the possibility that such a shift would result in a reduction of funding for Medicaid over time. Learn more about [...]

iqtsupport2017-02-02T06:00:53-05:00February 2, 2017|Medicaid|

MACPAC Meets, Discusses Medicaid DSH Issues

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. to review aspects of its required March report to Congress and to address other Medicaid and CHIP issues. Included on the agenda of the meeting were: a review of chapters of the March report on Medicaid disproportionate share (Medicaid DSH) and monitoring of access to care; alternative approaches to state financing of their Medicaid programs; Medicaid coverage for low-income adults; and Medicaid program integrity issues. See the presentations used to help guide these discussions here, on MACPAC’s web site.

iqtsupport2017-02-01T06:00:51-05:00February 1, 2017|Medicaid|

Defining “Success” in Addressing Social Determinants

With a growing number of programs designed to address the social determinants of individuals’ health care challenges, the question arises as to how to define “success” in those approaches. A recent article on the Health Affairs Blog addresses this question by illustrating the many variables that go into determining what constitutes “success” and suggesting that success be viewed from a number of perspectives, including: success for entire communities success from the perspective of individual patients success based on the effectiveness of addressing specific social needs (such as housing, transportation, or food security) The article also describes the different ways that [...]

iqtsupport2017-01-31T06:00:30-05:00January 31, 2017|Uncategorized|

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services. CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries. In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.

iqtsupport2017-01-27T06:00:22-05:00January 27, 2017|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, Medicaid, Medicare|

Medicaid Block Grants 101

Amid a great deal of speculation about the possibility of Congress and the new Trump administration turning Medicaid into a block grant program, Kaiser Health News has taken a step back to ask the question “What does this even mean?” Among the issues the new article addresses are: how a Medicaid block program might work how block grants differ from per capita caps why block grants are so interesting and so appealing to some public officials the chances of Medicaid becoming a block grant program See the Kaiser Health News article about Medicaid block grants here.

iqtsupport2017-01-26T13:00:32-05:00January 26, 2017|Medicaid|

Medicaid Directors Comment on Home and Community-Based Services

The National Association of Medicaid Directors has responded to a request for information published by the Department of Human Services seeking comment on the future of Medicaid-covered home and community-based services. See the association’s comments and recommendations here.

iqtsupport2017-01-26T06:00:15-05:00January 26, 2017|Medicaid|

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