Bulletin Board
Bulletin Board
Medicaid Directors Look at Value-Based Purchasing
One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue [...]
Serving High-Need, High-Cost Medicare Patients
With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the [...]
GAO Looks at MLTSS Rates, Oversight
Federal oversight of the manner in which states pay for Medicaid-covered managed long-term services and supports and of the data states use to set the rates for those services and supports is lacking, according to a new study by the U.S. Government Accountability Office. In a review of such practices in six states, GAO found that states are not adequately linking payments and penalties to performance toward achieving MLTSS goals for providing more care in the community and are using outdated data to set rates that federal regulations require to [...]
Cures Law Addresses Shortcomings in Readmissions Program
The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The [...]
Budget Reconciliation Explained
Congress may use the federal budget reconciliation process to repeal some aspects of the Affordable Care Act. But what is the budget reconciliation process and how does it work? Kaiser Health News has created a brief video, with an accompanying transcript, that explains. Find that video here.