joe, Author at DeBrunner & Associates

Acute Hospital Care at Home Shows Promise

The Acute Hospital Care at Home program, launched by the Centers for Medicare & Medicaid Services during the COVID-19 pandemic to free hospital beds for COVID and other sick patients, is showing promise as an alternative to hospital care for at least some patients. In an analysis of more than 5000 Medicare patients participating in the Acute Hospital Care at Home program from mid-2022 through mid-2023, only 0.5 percent of participants passed away while being served by the program at home and only 6.2 percent required a return to a hospital for more than 24 hours. With the waiver enacted [...]

joe2024-01-16T14:21:27-05:00January 17, 2024|Centers for Medicare & Medicaid Services, Medicare|

MedPAC Meets, Finalizes 2025 Payment Recommendations

2025 Medicare payments led the agenda at last week’s meeting of the Medicare Payment Advisory Commission. After hearing presentations on the various Medicare payment systems and discussing the adequacy of current Medicare reimbursement, MedPAC’s commissioners voted to recommend the following changes in 2025 Medicare payments. Inpatient and outpatient services – an update provided for in current law plus 1.5 percent and a shift to a safety-net index policy that would pay safety-net hospitals another $4 billion. Physicians and other health professionals – an increase of 50 percent of the Medicare economic index and introduction of an add-on payment for services [...]

joe2024-01-16T14:22:30-05:00January 16, 2024|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Medicare Underpayment of Hospitals Continues

Medicare paid hospitals only 82 percent of what they spent caring for Medicare patients in 2022, according to a new analysis. That amounted to a Medicare payment shortfall of nearly $100 billion. Learn more about these numbers, how they were calculated, and what they mean for hospitals and their Medicare patients from the American Hospital Association report “Medicare Significantly Underpays Hospitals for Cost of Patient Care.”

joe2024-01-11T19:41:33-05:00January 15, 2024|hospitals, Medicare|

Federal Health Policy Update for January 11

The following is the latest health policy news from the federal government for January 5 - 11. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS will establish 200 new Medicare-funded residency slots in FY 2025. Learn more about the additional slots here and find information about how to apply for those slots here. The deadline for applications is March 31. CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics. Medicare Part D plans must cover commercially available oral antivirals for COVID-19 [...]

joe2024-01-11T21:27:47-05:00January 11, 2024|hospitals, MACPAC, Medicaid, Medicare, Medicare reimbursement policy, Telehealth|

“Drivers of Health” Drive Most Health Outcomes

A recent analysis has found that newly coined “drivers of health” are the primary drivers of health outcomes. According to a Commonwealth Fund report, Research indicates that an estimated 20 percent of health outcomes are linked to medical care; the remaining 80 percent stem from socioeconomic, environmental, and behavioral factors referred to as social drivers of health (DOH). These factors – such as homelessness, food insecurity, and exposure to intimate partner violence – are associated with chronic illness, mental health issues, acute hospitalizations, and high health care costs and disproportionately impact communities of color. In its proposed 2023 Medicare physician [...]

joe2024-01-09T16:28:39-05:00January 9, 2024|Centers for Medicare & Medicaid Services, health equity, social determinants of health|

Federal Health Policy Update for January 4

The following is the latest health policy news from the federal government for December 21 to January 4. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the departments of Labor and the Treasury, and the Office of Personnel Management intend to reopen the comment period for submitting comments on a proposed rule governing federal Independent Dispute Resolution (IDR) operations. They plan to publish a notice to this effect in the near future with further details on reopening the comment period. Department of Health and Human Services HHS’s Office of the National Coordinator [...]

joe2024-01-04T22:10:23-05:00January 4, 2024|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Federal Update, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Expanded Mental Health Options Coming to Medicare

Beginning on January 1, Medicare beneficiaries will have access to more varied types of mental health services. At that time, mental health counselors and marriage and family therapists will become eligible to accept Medicare payments, joining the limited number of psychiatrists, psychologists, and social workers who have been serving the Medicare population as part of the first expansion of Medicare-eligible mental health providers since 1989. With Medicare planning to pay its new provider types 75 percent of what it pays psychologists, it is not clear how many of those new providers will be interested in enrolling as eligible Medicare providers. [...]

joe2023-12-21T15:22:53-05:00December 26, 2023|Medicare, Medicare reimbursement policy|

Federal Health Policy Update for December 20

The following is the latest health policy news from the federal government December 14-20. Some of the language used below is taken directly from government documents. Congress The House is in recess until January 9. The Senate has delayed its recess to continue negotiations on a possible foreign aid and border policy deal. Democrats from the House Ways and Means Committee have published a report on the relationship between the U.S. health care system and climate change. View their report “Health Care and the Climate Crisis: Preparing America’s Health Care Infrastructure.” No Surprises Act The federal government has reopened the [...]

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the meeting. MACPAC’s December 2023 meeting opened with a session that highlighted findings related to sexual orientation and gender identity (SOGI) data collection as part of the Commission’s focus on the collection of primary language and limited English proficiency, SOGI, and disability data for the purposes of assessing and addressing health disparities. During this discussion, we reviewed the purpose of SOGI data and federal and state priorities for collecting these data, which includes an overview of [...]

joe2023-12-19T15:36:42-05:00December 19, 2023|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for December 14

The following is the latest health policy news from the federal government for December 8-14. Some of the language used below is taken directly from government documents. MedPAC Rate Recommendations At their latest public meeting, members of the Medicare Payment Advisory Commission voted preliminary approval of the following rate updates for 2025 Medicare payments: Inpatient and outpatient services –update provided for in current law plus 1.5% and adoption of a safety-net index policy to pay safety-net hospitals another $4 billion. Physicians and other health professionals –update of 50% of the Medicare economic index and a new add-on payment for services [...]

joe2023-12-14T22:30:50-05:00December 14, 2023|340b, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

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