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“Hospital at Home” Appears to be Working Well

The federal Acute Hospital Care at Home program introduced during the COVID-19 crisis appears to be working well, according to a new study. The program, intended to free hospital beds at the height of the COVID pandemic while protecting non-COVID patients from exposure to the virus, enabled hospitals meeting certain Centers for Medicare & Medicaid Services criteria to care for Medicare fee-for-service and non-managed care Medicaid patients in the home. Participating patients were chosen according to CMS-approved safety criteria built around an assessment of the acuity of their medical conditions [...]

November 15, 2023|Categories: hospitals, Medicare|Tags: Acute Hospital Care at Home, COVID-19|

Improved Prospects for Non-Profit Hospital Finances in 2024

Non-profit hospitals should see generally improved financial performance in 2024, according to Moody’s Investor Services. Driving improved performance, according to the rating company, will be increased reimbursement that outpaces rising labor costs; increased volume, especially in the delivery of higher-margin outpatient care; and improved Medicaid payments in some states. Also helping improve hospital financial performance will be better use of IT, more use of telehealth, improved workflow, and better use of external resources for improving revenue cycle management. Learn more about what Moody’s sees ahead for non-profit hospitals in 2024 [...]

November 14, 2023|Categories: hospitals|Tags: hospital financial performance, non-profit hospital financial performance|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days recently in Washington, D.C. The following is MACPAC’s own summary of the meeting. To kick off MACPAC’s November meeting, the Commission continued its work on denials and appeals in Medicaid managed care with a review of findings from beneficiary focus groups. Medicaid managed care organizations (MCOs) manage and provide care to beneficiaries enrolled in their plans. Beneficiaries have the right to appeal MCO coverage decisions. Federal rules require that states have monitoring systems in place to provide oversight of [...]

November 14, 2023|Categories: Centers for Medicare & Medicaid Services, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicaid managed care, Medicaid regulations, Medicaid regulations for long-term care|Tags: MACPAC, Medicaid and CHIP Payment Advisory Commission, Medicaid and health disparities, Medicaid and home and community-based services, Medicaid and language proficiency and health disparities, Medicaid and school-based behavioral health services, Medicaid continuous coverage unwinding, Medicaid managed care, Medicaid managed care appeals process, Medicaid managed care organizations, Medicaid MCOs, Medicaid medical care advisory committees, Medicare Advantage dual eligible special needs plans|

MedPAC Meets

The commissioners of the Medicare Payment Advisory Commission recently met virtually. The subjects on the agenda of their two-day meeting were: rural emergency hospitals dual-eligible special needs plans MedPAC’s work plan for hospice issues Medicare coverage of and payment for software as a medical service favorable selection in Medicare Advantage network management and prior authorization and their impact on access in Medicare Advantage MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on either Congress or the administration, MedPAC is [...]

November 13, 2023|Categories: Medicare, Medicare post-acute care, Medicare reimbursement policy, post-acute care|Tags: dual-eligible special needs plans, Medicare Advantage, Medicare and hospice care, Medicare Payment Advisory Commission, MedPAC, rural emergency hospitals|

Federal Health Policy Update for November 9

The following is the latest health policy news from the federal government for November 3-9. Some of the language used below is taken directly from government documents. Congress Senate Finance Committee Earlier this week the Senate Finance Committee passed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023. The bill, which passed out of the committee by a vote of 26-0, would: eliminate $16 billion in cuts to Medicaid DSH for 2024 and 2025; soften the 2024 cut to Medicare physician payments by reducing the conversion factor [...]

November 9, 2023|Categories: 340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|Tags: 2023 continuing resolution, 340B, AHRQ News Now, Better Mental Health Care Lower-Cost Drugs and Extenders Act of 2023, Birthing Friendly hospital, health equity, HHS Office of Civil Rights, HHS Office of the Inspector General, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid and CHIP renewals, Medicaid and doulas, Medicaid and nursing home staffing requirements, Medicaid continuous eligibility rewinding, Medicaid disproportionate share, Medicaid DSH, Medicare Advantage, Medicare and behavioral health, Medicare Payment Advisory Commission, MedPAC, MLN Connects, proposed Medicare Advantage regulation|

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