hospitals

Moody’s: Tough Year Ahead for Non-Profit Hospitals

Non-profit hospitals may not fare well financially in 2019, suggests Moody’s Investor Services, the financial services and rating company. The challenge, according to Moody’s: Revenue growth will be constrained as the sector continues to face numerous challenges, including low patient volume growth and higher bad debt as co-pays and deductibles rise. In addition, Expense growth is anticipated to slow through cost-cutting measures and lower increases in drug prices. However, expenses will still outpace revenues due to the ongoing need for temporary nurses, continued recruitment of employed physicians, wage increases associated with lower unemployment, innovative specialty drugs, and increased use of [...]

iqtsupport2018-12-07T06:00:27-05:00December 7, 2018|hospitals|

CMS Proposes New Medicaid Managed Care Regulation

Just two years after a major overhaul of Medicaid managed care regulations, the Centers for Medicare & Medicaid Services is again proposing changes in how the federal government regulates the delivery of managed care services to Medicaid beneficiaries. Under the newly proposed regulation, states would: be free to implement more changes in their managed care programs without seeking federal permission; have slightly more flexibility in how supplemental payments are made to hospitals through managed care plans and implement some such changes without federal approval; be permitted to redefine what constitutes an adequate provider network for managed care plans; and not [...]

iqtsupport2018-11-14T06:00:22-05:00November 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

Medicare Site-Neutral Outpatient Payment Proposal Would Have Disproportionate Impact

The Centers for Medicare & Medicaid Services’ proposal to make more Medicare outpatient payments on a site-neutral basis would significantly cut Medicare’s overall outpatient spending but most of that cut would be borne by just a few hospitals. A report prepared for the Integrated Health Care Coalition concluded that …CMS’ Off-Campus Site-Neutral Proposal in the FY 2019 CMS OPPS [note: outpatient prospective payment system] NPRM [note: notice of proposed rulemaking] will disproportionate affect about six percent of 3,333 hospitals that participate in the program. 200 hospitals will shoulder 73 percent of the proposed payment reductions….For the top 200, the average [...]

iqtsupport2018-10-05T06:00:43-04:00October 5, 2018|hospitals, Medicare regulations|

State Court Upholds Non-Profit Hospital Tax Exemption

The Illinois Supreme Court has ruled in favor of non-profit hospitals in response to a challenge to their exemption from local property taxes. Upholding a 2016 lower court ruling, the state Supreme Court affirmed that non-profit hospitals’ charitable expenditures can be used to offset their local property tax liabilities. Learn more about the court’s decision in this article in Crain’s Chicago Business.

iqtsupport2018-09-28T06:00:35-04:00September 28, 2018|hospitals|

Operating Margins Lag for Non-Profit Hospitals

Non-profit hospitals’ operating margins fell from a median of 2.8 percent in 2016 to 1.9 percent in 2017, according to Fitch Ratings. Non-profit hospitals’ profitability also declined. Despite this, Fitch finds that these hospitals have strong balance sheets, with cash on hand and cash-to-debt ratios rising in the past year. It warns, though, that continuing declines in operating margins could eventually threaten those healthy balance sheets. Learn more about Fitch’s analysis in this summary of its ratings report.

iqtsupport2018-09-27T06:00:41-04:00September 27, 2018|hospitals|

CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers. The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work. Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself.

iqtsupport2018-09-24T06:00:42-04:00September 24, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations|

Medicare Joint Replacement Program Produces Savings

The first reporting period for Medicare’s Comprehensive Care for Joint Replacement Model found that participating providers cut costs for episodes of care by more than $900, or 3.3 percent. Most of the savings, the Centers for Medicare & Medicaid Services reports, were achieved by sending patients to less-expensive post-acute-care settings or by reducing patients’ length of stay in such facilities. CMS also found that the program’s mandatory participants, located in 67 metropolitan statistical areas, achieved these savings without compromising quality of care as measured by post-discharge emergency room visits, hospital readmissions, and deaths. Learn more about CJR’s early results in [...]

iqtsupport2018-09-14T06:00:50-04:00September 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare|

Low-Acuity Use of Emergency Departments Declines

People are using hospital emergency departments less frequently for low-acuity medical problems, turning instead to retail clinics and urgent care. According to a new study of a limited patient population published in JAMA Internal Medicine, Visits to the ED for the treatment of low-acuity conditions decreased by 36% (from 89 visits per 1000 members in 2008 to 57 visits per 1000 members in 2015), whereas use of non-ED venues increased by 140% (from 54 visits per 1000 members in 2008 to 131 visits per 1000 members in 2015). There was an increase in visits to all non-ED venues: urgent care [...]

iqtsupport2018-09-12T06:00:33-04:00September 12, 2018|hospitals|

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.” In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action. For hospitals, they wrote that they seek further red-tape cutting in the areas of [...]

iqtsupport2018-09-11T06:00:49-04:00September 11, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations|

Congress Asks MedPAC to Look at Hospital Consolidation

The House Energy and Commerce Committee has asked the Medicare Payment Advisory Commission to examine the impact of hospital consolidation on patients and federal health care spending. In a letter signed by Energy and Commerce Committee chairman Greg Walden (R-OR), Health Subcommittee chairman Michael Burgess (R-TX), and Oversight and Investigations Subcommittee chairman Gregg Harper (R-MS), the Energy and Commerce Committee states that We request the Medicare Payment Advisory Commission (MedPAC) conduct research examining questions regarding the market trend of hospital consolidation and the degree to which such consolidation increases cost to the Medicare program and beneficiaries, including the costs for [...]

iqtsupport2018-09-07T06:00:18-04:00September 7, 2018|hospitals, Medicare, MedPAC|