hospitals

Surprise! Teaching Hospitals Cost Less Than Non-Teaching Hospitals

30-day and episode-of-care costs are lower for care provided by major teaching hospitals than they are for other teaching hospitals and non-teaching hospitals. Or so concludes a new study published by JAMA Open Network. According to the study: Major teaching hospitals’ initial hospitalization costs are higher. Major teaching hospital costs are less than other hospitals after 30 days of care and over entire episodes of care. Major teaching hospitals’ costs are similar to those of other teaching hospitals and non-teaching hospitals over a 90-day episode of care. Major teaching hospitals’ patients incurred lower costs for post-acute care. Major teaching hospitals [...]

iqtsupport2019-06-13T06:00:38-04:00June 13, 2019|hospitals, Medicare|

Uninsured ED and Inpatient Visits Down Since ACA

Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act. And Medicaid-covered admissions and ER visits are up, according to a new analysis. The report, published on the JAMA Network Open, found that ER visits by uninsured patients fell from 16 percent to eight percent between 2006 and 2016, with most of this decline after 2014, while uninsured discharges fell from six percent to four percent. The rate of uninsured ER visits declined, moreover, at a time when overall ER visits continued to rise. While the Affordable Care Act is likely the cause of [...]

iqtsupport2019-05-01T06:00:26-04:00May 1, 2019|Affordable Care Act, hospitals, Medicaid|

CMS Posts Proposed FY 2020 Inpatient Regulation

Medicare would change its wage index system, raise inpatient fees, increase funding for Medicare disproportionate share hospital payments (Medicare DSH), enhance payments for new technologies, and make minor modifications in its hospital readmissions reduction, value-based purchasing, and hospital-acquired condition program if a proposed regulation published this week is ultimately adopted. The Centers for Medicare & Medicaid Services has published its proposed FY 2020 Medicare inpatient prospective payment system regulation: its plan for paying acute-care hospitals for Medicare-covered inpatient services in FY 2020. The 1800-page regulation calls for major changes in Medicare’s wage index system – changes CMS says would “…address [...]

iqtsupport2019-04-25T06:00:11-04:00April 25, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|

Groups Seek Funding for Children’s Hospital Graduate Medical Education

Provide $400 million in funding for children’s hospital graduate medical education programs in the FY 2020 budget, 28 groups have asked congressional leaders in a recent letter. The letter, sent to the chairs and ranking members of the Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services, and Related Agencies and the same subcommittee of the House Appropriations Committee, notes that Sustaining pediatric training programs at children’s hospitals to meet the need of children, now and in the future, requires bolstering our national commitment. Support for training pediatric providers through CHGME (children’s hospitals graduate medical education) lags behind the [...]

iqtsupport2019-04-18T06:00:17-04:00April 18, 2019|hospitals|

MACPAC Recommends Changes in Medicaid Shortfall Definition

Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress. That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments. Last week the Medicaid and CHIP Payment and Access Commission voted overwhelmingly to change how hospitals calculate their Medicaid shortfall: the difference between what they spend caring for their Medicaid patients and what Medicaid pays them for that care. Under MACPAC’s proposal, hospitals would need to deduct from their shortfall total all third-party payments they receive for the care they provide to their Medicaid patients. If this proposal were to [...]

iqtsupport2019-04-17T06:00:13-04:00April 17, 2019|hospitals, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

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 April agenda were: Expanding the use of value-based payment in Medicare Medicare Shared Savings Program performance Redesigning the Medicare Advantage quality bonus program Increasing the accuracy and completeness of Medicare Advantage encounter data Evaluating patient functional assessment data reported by post-acute-care providers Options for slowing the growth of Medicare fee-for-service spending for emergency department services Options to increase the affordability of specialty drugs and biologics in Medicare Part D Improving payment for low-volume and isolated outpatient dialysis [...]

iqtsupport2019-04-09T06:00:04-04:00April 9, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Prospects Mixed for Non-Profit Hospitals in 2019

There’s good news and bad news for non-profit hospitals in 2019, according to Fitch Ratings, the bond-rating company. The good news: For many, major IT investments have been completed. Many have adjusted to the reality of falling inpatient volume. Many that saw reduced margins as a result of launching, purchasing, or participating in provider-sponsored plans to compete in health exchanges have scaled back those efforts. The bad: profits and margins may continue to decline – but those declines will not be as steep as they have been in recent years. Reimbursement may be weaker, too. Learn more from the Fierce [...]

iqtsupport2019-04-01T10:17:11-04:00April 1, 2019|hospitals|

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 [...]

iqtsupport2019-03-29T06:00:00-04:00March 29, 2019|Affordable Care Act, health care reform, hospitals, Medicaid|

Mixed Verdict: Home Health Leads to More Readmissions But Lower Costs

Readmission rates are greater for patients discharged from hospitals to home health care than they are for those discharged to skilled nursing facilities but home health services cost so much less than nursing homes that home health saves money even with the higher numbers of hospital readmissions. This is one of the major findings of a new study comparing differences in outcomes for patients who are admitted to skilled nursing facilities upon discharge from the hospital to those for patients who go direct home and receive home health services. The study also found no meaningful differences in patient mortality or [...]

iqtsupport2019-03-22T06:00:57-04:00March 22, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy|

MACPAC Makes DSH, UPL Recommendations

Changes could come in Medicaid DSH and UPL payments if new MACPAC recommendations are adopted. Last week the Medicaid and CHIP Payment and Access Commission released its annual report to Congress, with most of the report focusing on its analysis and recommendations for policy updates involving Medicaid disproportionate share hospital payments (Medicaid DSH) and Medicaid upper payment limit payments (UPL payments). With Affordable Care Act-mandated cuts in Medicaid DSH payments scheduled to start in FY 2020 – this coming October – MACPAC recommended that these cuts be reduced and phased in over a longer period of time “…to give states [...]

iqtsupport2019-03-20T13:00:48-04:00March 20, 2019|hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid upper-payment limit|