hospitals

Hospitals Sue Over Hospital Price Transparency Requirement

The federal government should be prohibited from implementing its new price transparency requirement for hospitals, a group of hospital trade groups and health systems has declared in a lawsuit against the U.S. Department of Health and Human Services. The requirement exceeds the federal government’s authority, the suit maintains, and its implementation would create an undue burden on hospitals, cost a great deal of money, require hospitals to divulge proprietary information, inhibit competition, and overwhelm their information systems. Even after all of that, the suit claims, consumers would still not have useful information because insurers, not hospitals, are the key in [...]

iqtsupport2019-12-06T06:00:38-05:00December 6, 2019|hospitals, Medicare regulations|

High-Deductible Plans Driving Rise in Hospital Bad Debt

Hospital bad debt rose in 2018 after several years of decline, and according to Moody’s, high-deductible health insurance is one of the major drivers of that increase. According to the bond rating agency, non-profit hospitals are seeing growing amounts of bad debt as they struggle, often unsuccessfully, to collect from patients whose high deductibles leave them on the hook for meaningful amounts of care. Kaiser Health News reports that 28 percent of covered workers, nearly half of them working for companies with fewer than 200 employees, now have health plan deductibles of at least $2000. That proportion of individuals with [...]

iqtsupport2019-12-02T06:00:45-05:00December 2, 2019|hospitals|

Hospitals Sue HHS Over Payment Cut

Medicare cut hospital payments $840 million a year more than it should have and now, hospitals are suing to get their money back. According to the lawsuit, Congress authorized Medicare to include a cut of 0.7 percent in hospital inpatient payments through FY 2017 to recoup past Medicare overpayments but Medicare continued the cut, without Congress’s approval, in FY 2018 and FY 2019. The 600 hospitals that filed the suit estimate that the allegedly illegal cut cost them about $200,000 each and now, they want their money back – with interest. Learn more in the Becker’s Hospital Review article “622 [...]

iqtsupport2019-11-26T06:00:10-05:00November 26, 2019|hospitals, Medicare cuts, Medicare reimbursement policy|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s November agenda were: congressional request on health care provider consolidation increasing the supply of primary care physicians redesigning the Medicare Advantage quality bonus program reforming the benchmarks in the Medicare Advantage payment system considerations for plans serving low-income beneficiaries in the restructuring of Medicare Part D post-acute care spending under the Medicare Shared Savings Program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on [...]

iqtsupport2019-11-12T06:00:16-05:00November 12, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

MACPAC Looks at Medicaid DSH

At a time when cuts in Medicaid disproportionate share hospital payments (Medicaid DSH) are still scheduled for the current fiscal year and some in Congress are calling for a new approach to allotting DSH funds among the states, the Medicaid and CHIP Payment and Access Commission has released its annual analysis of Medicaid DSH allotments to the states. The report includes: data about changes in the uninsured rate demographic information about the uninsured information about the cost of hospital uncompensated care perspectives on hospital Medicaid shortfalls a comparison of hospital uncompensated care costs when calculated using different methodologies data about [...]

iqtsupport2019-11-08T06:00:27-05:00November 8, 2019|hospitals, MACPAC, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

More Hospitals Gain Than Lose in FY 2020 Value-Based Purchasing Program

Medicare’s value-based purchasing program will reward more hospitals than it will penalize in FY 2020 through its value-based purchasing program. The program, in which 2700 hospitals are scored in four domains – clinical outcomes, safety, person and community engagement, and efficiency and cost reduction – will distribute $1.9 billion in bonus payments to 1500 hospitals. Bonus payment average 0.6 percent, with a high of 2.93 percent. Penalties average -0.39 percent, with a high of -1.72 percent. Overall, rural hospitals performed better in the safety, person and community engagement, and efficiency and cost reduction categories and had a higher average score [...]

iqtsupport2019-10-30T15:15:04-04:00October 30, 2019|hospitals, Medicare, Medicare reimbursement policy|

Tools for Controlling Cost Growth Limited

Employers and insurers sometimes have limited means of reducing growth in health care costs, a new study has found. While hospitals can take incremental steps to manage rising costs, those efforts will be outstripped in geographic markets that have undergone a great deal of consolidation, according to a new analysis from the Georgetown University Health Policy Institute. In areas of such consolidation, the study found, insurers can be reluctant to negotiate hard with hospitals and health systems or to threaten to exclude those providers from their networks and businesses, rather than backing insurers or pressuring providers, are more likely to [...]

iqtsupport2019-10-30T06:00:25-04:00October 30, 2019|hospitals|

It’s Hospitals’ Turn to Sue Opioid Makers

Hospitals are now joining cities and states in suing opioid makers for the financial damages their products have caused. In Arizona, Florida, Kentucky, Mississippi, Tennessee, Texas, and West Virginia, hundreds of hospitals are now suing opioid makers in state courts to seek compensation for the unreimbursed costs they incurred caring for uninsured patients who came to them suffering from overdoses and addiction. For the most part, the most prominent hospitals and health systems in these states have not joined the suits. According to court documents, the suing hospitals estimate that it cost them an average of $107,000 to treat complicated [...]

iqtsupport2019-10-26T06:00:04-04:00October 26, 2019|hospitals|

Court Halts Medicare Site-Neutral Payment Changes

The Centers for Medicare & Medicaid Services did not have the authority to implement the site-neutral payment system for Medicare-covered outpatient services that it introduced last year, a federal court has concluded. According to the court, CMS exceeded its authority because it …was not authorized to ignore the statutory process for setting payment rates in the Outpatient Prospective Payment System and to lower payment rates only for certain services provided by certain providers. In general, hospitals oppose the movement toward site-neutral payments and independent physician groups support it. The court did not order CMS to reimburse affected physician practices for [...]

iqtsupport2019-09-19T06:00:43-04:00September 19, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, Medicare reimbursement policy|

MedPAC Weighs in on Proposed Medicare Payment Changes

The Medicare Payment Advisory Commission has submitted formal comments to the Centers for Medicare & Medicaid Services in response to the latter’s publication of a proposed regulation that would govern how Medicare will pay for acute-care hospital inpatient services and long-term hospital care in the coming 2020 fiscal year. The 14-page MedPAC report addresses four aspects of the proposed Medicare payment regulation: inpatient- and outpatient drug- and device related payment proposals proposed changes in the hospital area wage index the reporting of hospitals’ uncompensated care on the Medicare cost report’s S-10 worksheet the long-term hospital prospective payment system MedPAC is [...]

iqtsupport2019-06-26T06:00:55-04:00June 26, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, MedPAC, post-acute care|