Bulletin Board
Bulletin Board
DSRIP Evolves
Medicaid Delivery System Reform Incentive Payment waivers, unleashed by the Affordable Care Act and other Obama administration initiatives, sought to foster a greater focus on value in the delivery of health care. Medicaid DSRIP waivers typically provided new Medicaid funds to health care organizations that met performance goals for improving the quality of care, improving health care outcomes, and improving health care infrastructure in ways that improved care quality and outcomes. To a significant extent, early DSRIP programs helped protect Medicaid payments to hospitals that were jeopardized by hospital-specific and [...]
Verma Speaks at Medicaid Managed Care Summit
Centers for Medicare & Medicaid Services administrator Seema Verma recently addressed the Medicaid Managed Care Summit, which was held in Washington, D.C. Ms. Verma’s speech focused on four major areas: Empowering states to function as laboratories for innovation by giving them the flexibility to introduce changes that work best for their own citizens. Developing Medicaid and CHIP scorecards that present data on health outcomes, quality metrics, and CMS’s administrative performance. Improving Medicaid program integrity, including through “…targeted audits to ensure that provider claims for actual health care spending match what [...]
OIG: Medicare Advantage Plans May be Denying Access to Save Money
The Office of the Inspector General of the U.S. Department of Health and Human Services is concerned that Medicare Advantage plans may be denying their members access to services to save money and increase profits. According to the OIG, those Medicare Advantage plans overturn 75 percent of their own denials of service upon appeal and independent reviewers are overturning still more denials. In the OIG’s view, this high rate of service denials raises concerns that Medicare Advantage plans, which today serve more than 20 million seniors, are denying their members [...]
New Approach to Readmissions Program to Take Effect October 1
Medicare’s hospital readmissions reduction program will move in a new direction beginning in FY 2019 after Congress directed the Centers of Medicare & Medicaid Services to compare hospitals’ performance on readmissions to similar hospitals instead of to all hospitals. The policy change, driven by a belief that safety-net hospitals were harmed by the program and excessive penalties because their patients are more challenging to serve, results in all hospitals being divided into peer groups based on the proportion of low-income patients they serve. The readmissions performance of hospitals is then [...]
State Court Upholds Non-Profit Hospital Tax Exemption
The Illinois Supreme Court has ruled in favor of non-profit hospitals in response to a challenge to their exemption from local property taxes. Upholding a 2016 lower court ruling, the state Supreme Court affirmed that non-profit hospitals’ charitable expenditures can be used to offset their local property tax liabilities. Learn more about the court’s decision in this article in Crain’s Chicago Business.