hospitals

Hospitals Sue Over Site-Neutral Outpatient Payment Policy

Nearly 40 hospitals have filed a joint lawsuit in opposition to the Centers for Medicare & Medicaid Services’ site-neutral payment policy for Medicare-covered outpatient services. In the suit, the hospitals charge the federal government with overstepping its authority in implementing such a change through regulation in the face of past congressional action to limit the use of site-neutral payments. Under its site-neutral payment policy, Medicare pays the same for some outpatient services regardless of where those services are provided. Under Medicare’s previous policy, Medicare paid more for services provided in hospital-run outpatient facilities. Hospitals argue that their outpatient facilities are [...]

iqtsupport2019-01-30T06:00:38-05:00January 30, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, Medicare reimbursement policy|

Hospitals Flee Downside Risk in Medicare Bundled Programs

More than half of the hospitals that voluntary participate in Medicare bundled payment model programs leave those programs when faced with the possibility of financial penalties based on their performance. So concludes a new report by the U.S. Government Accountability Office. Some of these models feature both “upside” and “downside” risk. Upside risk offers financial incentives to participants that keep their costs below targeted amounts; they share those savings with Medicare. Downside risk occurs when hospitals are penalized when their costs exceed agreed-upon targets. Some of the model programs begin with only upside risk and later move into both upside [...]

iqtsupport2019-01-29T06:00:06-05:00January 29, 2019|Alternative payment models, hospitals, Medicare|

No Medicaid Expansion=Greater Peril for Rural Hospitals

Rural hospitals located in states that did not expand their Medicaid programs, as authorized by the Affordable Care Act, are at much greater risk of closing than hospitals in states that did expand their Medicaid programs. According to a Stateline report, most of the 100 rural hospitals that have closed since 2010 and most of the more than 600 rural hospitals that are considered to be in danger of closing now are located in states like Texas, Mississippi, and 12 others that have not expanded their Medicaid programs. Small rural hospitals that have not closed serve large proportions of uninsured [...]

iqtsupport2019-01-28T06:00:27-05:00January 28, 2019|Affordable Care Act, hospitals, Medicaid|

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 December agenda were: The Medicare prescription drug program (Part D) Opioids and alternatives in hospital settings: payments, incentives, and Medicare data Hospital inpatient and outpatient services payments Redesigning Medicare’s hospital quality incentive programs Physicians and other health professional services payments Medicare payment policies for advanced practice registered nurses and physician assistants Ambulatory surgical centers and hospice payments Skilled nursing facilities, home health agency, and inpatient rehabilitation facilities payments Long-term care hospital services payments Outpatient dialysis payments Future [...]

iqtsupport2019-01-24T06:00:53-05:00January 24, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, MedPAC|

S&P: Stable 2019 for Non-Profit Hospitals

Non-profit hospitals should experience a relatively stable 2019, according to S&P Global Financial. The bond-rating company estimates that 81 percent of such hospitals will be stable this year, with roughly equal numbers of hospitals looking at upgrades and downgrades. This stability is being driven by strong balance sheets and diversification while challenges to hospital financial performance and stability include the possibility of a recession, rising costs for serving an aging population, changes in Medicaid eligibility and payment policies, and the continued emergence of non-traditional health care providers. S&P also concludes that hospital operating margins are recovering after years of investment [...]

iqtsupport2019-01-22T06:00:30-05:00January 22, 2019|hospitals|

Hospital Uncompensated Care Unchanged in 2017

Despite a modest increase in the uninsured rate, hospital uncompensated care in 2017 was $38.4 billion, essentially the same as it was in 2016 and down from the all-time high of $46.8 billion in 2013. This comes from an American Hospital Association survey that also found that in 2017, hospital admissions and inpatient days rose modestly hospital outpatient visits and surgeries increased emergency room visits declined the proportion of for-profit hospitals declined the number of rural hospitals fell Learn more in the Healthcare Dive article “Uncompensated care costs flat in 2017 despite uptick in uninsured.”

iqtsupport2019-01-11T06:00:13-05:00January 11, 2019|hospitals|

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 December agenda were: Medicare payments for physician and other health professionals services payments for ambulatory surgical centers payments for hospital inpatient and outpatient care Medicare’s hospital quality incentive program payments for skilled nursing facilities payments for long-term care hospitals payments for inpatient rehabilitation facilities payments for outpatient dialysis services payments for hospice care payments for home health services the Medicare Advantage program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. [...]

iqtsupport2018-12-11T06:00:45-05:00December 11, 2018|hospitals, Medicare, Medicare reimbursement policy, MedPAC|

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|