health care reform

CMS Solicits Waiver Input From Stakeholders

The Centers for Medicare & Medicaid Services is soliciting ideas from stakeholders about new approaches that might be employed in the development of state relief and empowerment waivers, also known as section 1332 waivers. Last year CMS loosened section 1332 waiver requirements and offered states four concepts for how to take advantage of both the waivers and the less stringent requirements.  Section 1332 waivers permit states to seek exemption from selected requirements of the Affordable Care Act to pursue new approaches to enhancing access to quality, affordable health insurance.  Through a new request for information, CMS now seeks …to build [...]

ACA Repeal Would Drive Up Uninsured, Uncompensated Care

At the same time that the Trump administration announced that it has asked a federal court to repeal the entire Affordable Care Act, the Urban Institute has published a report detailing the potential impact of the health care reform law’s repeal. According to the Urban Institute report, repealing the entire Affordable Care Act would add almost 20 million Americans to the ranks of the uninsured.  Medicaid and CHIP enrollment would fall by 15.4 million people and millions of others would lose the tax credits they used to purchase insurance.  Some would purchase insurance with limited benefits and individual plan premiums [...]

“Rejected” Medicaid Reforms May Resurface

Partial Medicaid expansion, desired by some Republican governors but rejected by the Trump administration last year, may not be so rejected after all. At least not according to Seema Verma, administrator of the Centers for Medicare & Medicaid Services, which oversees the federal Medicaid program. In a recent interview, Verma said the administration is reconsidering its rejection of partial Medicaid expansion, an idea she supports and that What I have said to states and to governors [is] “Tell me what you want to do, and it’s my job to help you get to where you want to go.” To emphasize [...]

2019-03-18T06:00:23-04:00March 18, 2019|health care reform, Medicaid|

CMS Introduces New Waivers

The Centers for Medicare & Medicaid Services has introduced four new “state relief and empowerment waivers” that are widely viewed as new vehicles for states to circumvent Affordable Care Act requirements to implement their own new approaches to health care. Through “account-based subsidies” waivers, states may direct public subsidies into defined-contribution, consumer-directed accounts that individuals use to pay for health insurance premiums or other health care expenses. “State-specific premium assistance” waivers enable states to create their own subsidy programs. “Adjusted plan options” authorizes states to provide financial assistance for different types of health insurance plans, including short-term and other health [...]

2018-12-03T06:00:13-05:00December 3, 2018|Affordable Care Act, health care reform|

Hospital Government Payment Losses Could Reach $218 Billion by 2028

A recent study concluded that hospitals can expect to lose about $218 billion in federal Medicare and Medicaid payments between 2010, when the latest round of major cuts began, and 2028. Among those cuts cited in the study, which was commissioned by the American Hospital Association and the Federation of American Hospitals, are: $79 billion for DRG documentation and coding adjustments $73 billion for Medicare sequestration $26 billion for Medicaid disproportionate share payments (Medicaid DSH) $11 billion in cuts associated with the American Taxpayer Relief Act of 2012 Other cuts came, or will be coming, through regulatory changes, the introduction [...]

Programs, Not Penalties, Drive Readmission Reductions

Participating in federal value-based payment programs does more to reduce hospital readmissions than penalties levied on hospitals with too many readmissions. Or so reports a new study published by JAMA Internal Medicine. According to the study, hospitals that participated in one or more of three Medicare value-based payment programs ­– its meaningful use of electronic health records program, the bundled payment for care initiative, or an accountable care organization (ACO) program – enjoyed bigger decreases in their avoidable Medicare readmissions than hospitals that participated in no such programs but were only subject to financial penalties levied under the Medicare hospital [...]

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