Bulletin Board
Bulletin Board
Docs Not Scoring Performance Bonuses
Relatively few physicians will receive Medicare pay-for-performance bonuses under Medicare’s value-based modifier program in 2018. The question now is whether this is because of uninspiring performance or indifference to the program. Of the approximately 1.1 million clinicians who participate in Medicare, only two percent – 22,000 – will receive pay increases in 2018 based on their 2016 performance. Those raises will range from 6.6 percent to 19.9 percent. Most doctors will receive neither bonuses nor penalties. And roughly 300,000 failed to submit the data required by the program. In the [...]
Medicaid in the Spotlight
State-option work requirements. A cap on federal spending. New flexibility for states to address eligibility, benefits, and provider payments. Rolling back the Affordable Care Act’s eligibility expansion. Medicaid is under the policy microscope in Washington these days in ways it has not been for many years as the new administration continues to work to put its stamp on the federal government’s major program to provide health care to low-income Americans. What are policy-makers considering and what are the potential implications of their efforts? Learn more in the new Health Affairs [...]
Conflicts of Interest Mar HCBS
States’ efforts to provide home- and community-based services to elderly and disabled Medicaid beneficiaries who need assistance to continue living independently continue to be plagued with conflicts of interest that the Centers for Medicare & Medicaid Services is not adequately addressing. Or so concludes a new study published by the U.S. Government Accountability Office. According to the GAO, …conflict of interest remain in regard to HCBS providers and managed care plans. HCBS providers may have a financial interest in the outcome of needs assessments, which could lead to overstating needs [...]
Safety-Net Hospitals Under the Gun
Safety-net hospitals across the country face a new challenge: adjusting to several cuts in the supplemental payments they receive from the federal government to help them serve the low-income residents of the communities in which they are located. First there is a $2 billion cut in Medicaid disproportionate share hospital payments (Medicaid DSH). These are payments made to hospitals that serve especially large numbers of low-income patients. These payments help safety-net hospitals with the unreimbursed expenses they incur caring for such patients. This cut, mandated by the Affordable Care Act [...]
MedPAC Meets
Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C. During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects: a Medicare Advantage status report a Medicare prescription drug program (Part D) status report hospital inpatient and outpatient payments physician payments ambulatory surgical center, dialysis center, and hospice payments post-acute care facility payments the hospital readmissions reduction program telehealth accountable care organizations Go here to see the issue briefs and presentations used during the [...]