joe, Author at DeBrunner & Associates

Study Finds Differences in Medicare Advantage Hospitalization Trends

Patients who participate in Medicare Advantage plans spend more time as hospital inpatients but receive less post-acute care than those in traditional Medicare, a new study has found. According to NORC, a non-partisan research organization at the University of Chicago, Medicare Advantage patients had hospital stays that were 40% longer on average than those with Traditional Medicare, which comes to seven days versus five. In 2022, Medicare Advantage plans discharged fewer patients to post-acute care settings such as skilled nursing or home health compared to patients covered by Traditional Medicare. According to NORC, “These disparities suggest that Medicare Advantage beneficiaries [...]

joe2025-06-24T16:21:34-04:00June 25, 2025|Medicare, Medicare post-acute care|

Federal Health Policy Update for June 19

The following is the latest health policy news from the federal government for June 13-19. Some of the language used below is taken directly from government documents. Congress The Senate Finance Committee The Senate Finance Committee has released its portion of the FY 2025 budget reconciliation bill. Major proposals include: A freeze on the size of Medicaid provider taxes, phased down reductions of current taxes toward a new, lower limit for many states, and new terms under which provider taxes can be approved. New limits on the use of Medicaid state directed payments so they eventually will not exceed 100 [...]

joe2025-06-19T16:17:10-04:00June 19, 2025|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 12

The following is the latest health policy news from the federal government for June 6-12. Some of the language used below is taken directly from government documents. Congress Republican senators continue to work on their version of a reconciliation bill with a goal of passage by July 4, although that deadline may slip. Some Senate committees have begun releasing their portions of the bill but the Finance Committee’s bill, with its tax and Medicaid provisions, has not yet been released. Among the majority party in the Senate, fault lines around the House-passed reconciliation bill remain around Medicaid provider taxes, state [...]

joe2025-06-12T16:32:26-04:00June 12, 2025|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

HHS Releases Proposed Budget

The Department of Health and Human Services has released a new, expanded version of its proposed FY 2026 budget. In some areas this version provides more detail than the administration shared in early May when it released a so-called “skinny budget” and some aspects of the budget proposal differ from the May release. Highlights of the most recent proposal include: A reduction of 25 percent, from $126 billion to $94.7 billion, in HHS’s overall discretionary (non-mandatory) spending. The consolidation of HHS’s 28 current operating divisions into 15 divisions. A reduction of $661 million, or 11 percent, in discretionary spending for [...]

joe2025-06-11T12:29:44-04:00June 12, 2025|340b, Centers for Medicare & Medicaid Services|

Administration Targets State Directed Medicaid Payments

The White House has issued a presidential memorandum on “Eliminating Waste, Fraud, and Abuse in Medicaid” that cites Medicaid “state-directed payments” as a form of waste, fraud, and abuse. According to the memorandum, states use state directed payments to pay more than Medicare rates for some Medicaid-covered services – something the memorandum suggests is contrary to current practice because “…billable costs for such care were historically capped at the same level that healthcare providers could receive from Medicare.” This assertion comes despite a 2024 regulation that set the payment limit for state directed payments at the average commercial rate and [...]

joe2025-06-11T10:22:01-04:00June 11, 2025|Medicaid, Medicaid managed care, Medicaid regulations|

CMS Charts Medicare’s Tech Future

In the wake of issuing a request for information asking stakeholders how the agency can better serve Medicare beneficiaries, the Centers for Medicare & Medicaid Services has begun charting its future use of technology by laying out some of the objectives of such an undertaking. In a recent news release, CMS identified the following objectives: Building a dynamic, interoperable national provider directory. Bringing modern identity verification processes to Medicare.gov to streamline credentials across the healthcare system. Expanding functionality of CMS’ Blue Button 2.0 patient access application programming interface (API). Transitioning CMS’s Data at the Point of Care pilot to general availability. [...]

joe2025-06-05T15:53:32-04:00June 10, 2025|Medicare|

Hospital Charity Care, Debt Collection Practices Vary

An analysis of the charity care policies of 2500 hospitals found considerable variation in their practices and in their efforts to collect unpaid bills. According to a review by the Lown Institute, most hospitals offer charity care but the income thresholds for qualifying for such assistance vary widely from hospital to hospital, from as low as household income of 100 percent of the federal poverty level to as much as 600 percent of the federal poverty level. Those standards vary, moreover, even in the same community, with neighboring hospitals sometimes having considerable differences in their thresholds for providing some or [...]

joe2025-06-05T14:41:09-04:00June 9, 2025|hospitals|

Federal Health Policy Update for June 5

The following is the latest health policy news from the federal government for May 30 to June 5. Some of the language used below is taken directly from government documents. Congress Congress returned to Washington D.C., where Republican senators continue to work on their version of a reconciliation bill with a goal of passage by the full Congress by July 4. Some Senate committees have begun releasing their portions of the bill but the committees with jurisdiction over Medicaid – the Finance and Health, Education, Labor, and Pensions (HELP) committees – have not committed to a timeline for their bills. [...]

joe2025-06-05T16:50:48-04:00June 5, 2025|Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for May 29

The following is the latest health policy news from the federal government for May 23-29. Some of the language used below is taken directly from government documents. Congress The House and Senate are out of Washington, D.C. this week for the Memorial Day holiday and will return to Washington on June 3. Senate Republican staff is working on the House-passed reconciliation bill to identify provisions that may need to change or be excluded to comply with the Senate’s rules for reconciliation bills. At the same time, some Republican senators have expressed opposition to the House reconciliation bill; some maintain that [...]

joe2025-05-29T15:36:56-04:00May 29, 2025|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

joe

About joe