Bulletin Board
Bulletin Board
MedPAC Meets
The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: using payments to ensure appropriate access to and use of hospital emergency department services uniform outcome measures for post-acute care applying MedPAC’s principles for measuring quality: hospital quality incentives Medicare coverage policy and use of low-value care long-term issues confronting Medicare accountable care organizations managed care plans for dual-eligible beneficiaries While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, [...]
Medicaid is Toughest Insurer for Providers
Medicaid is the hardest insurer for providers when it comes to billing. Or so reports a new study published in the journal Health Affairs. According to this analysis, Medicaid claims take longer to file, are more likely to be rejected, more likely to be challenged, and take longer to be paid than Medicare and private insurance claims. While the biggest problem is Medicaid fee-for-service claims, even Medicaid managed care claims pose more problems than Medicare and private insurance claims. Learn more about the challenges providers face when working with Medicaid [...]
Eat! You’ll Feel Better
And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food: some received general meal deliveries while others received food tailored to their individual medical conditions. The purpose: address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants [...]
Tackling Social Determinants of Health
The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients. A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations: Developing the business case,” seeks to serve as a manual for providers seeking to move [...]
Senate Committee Looks at 340B Program
The Senate Health, Education, Labor, and Pensions Committee (HELP) held a hearing last week on the 340B prescription drug discount program. The hearing was prompted by complaints from pharmaceutical companies about the discounts they are required to provide to eligible providers and by concern that hospitals are insufficiently accountable for how they use the savings they derive from those discounts to serve their low-income patients. In addition, the Centers for Medicare & Medicaid Services recently reduced its Medicare payments to participating hospitals. During the hearing, Senate Republicans expressed support for [...]