hospitals

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 [...]

2018-09-12T06:00:33-04:00September 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 [...]

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 [...]

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

Large Number of Hospitals on the Critical List

Eight percent of American hospitals – 450 of them – are at risk of closing in the coming years and another 10 percent, or 600 hospitals, are considered “weak” according to a new analysis performed by Morgan Stanley.  The signs of these problems include sinking margins, declining occupancy and revenue, and government and insurer policies that enable patients to receive certain services at facilities other than hospitals, as they did in the past. The largest concentrations of at-risk hospitals can be found in Texas, Oklahoma, Louisiana, Kansas, Tennessee, and Pennsylvania. Learn more about the Morgan Stanley analysis in this Bloomberg [...]

2018-08-29T06:00:35-04:00August 29, 2018|hospitals|

New Reg Pushes Medicare Toward Site-Neutral Outpatient Payments

Medicare would make more payments for outpatient services on a site-neutral basis under a newly proposed regulation just released by the Centers for Medicare & Medicaid Services. The 2019 Medicare outpatient prospective payment system regulation, published in proposal form, calls for: paying physician fee schedule rates rather than hospital outpatient rates at excepted off-campus provider-based departments; slashing payments for office visits; extending this year’s 340B prescription drug discount payments, already cut nearly 30 percent this year, to additional providers; and raising ambulatory surgical center rates and expanding the list of procedures that can be performed in such facilities so they [...]

Outcomes Strong at Academic Medical Centers

Patients served at academic medical centers have a better chance of surviving the health problems that brought them to those facilities. Or so concludes a new study published in the journal Health Affairs. According to the study, We examined more than 11.8 million hospitalizations in the period 2012–14 for Medicare beneficiaries ages sixty-five and older and found that, after adjustment for patient and hospital characteristics, high-severity patients had 7 percent lower odds, medium-severity patients had 13 percent lower odds, and low-severity patients had 17 percent lower odds of thirty-day mortality when treated at an academic medical center for common medical conditions, compared to similar [...]

2018-07-06T06:00:14-04:00July 6, 2018|hospitals|

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 [...]

Uninsured Rise Could Hurt Non-Profit Hospitals

The recent growth in the number of uninsured Americans could be especially harmful to non-profit hospitals and health systems, according to S&P Global Ratings. As reported by Healthcare Dive, S&P believes that because non-profit hospitals serve larger proportions of uninsured patients, they are more vulnerable to increases in the number of uninsured people.  Healthcare Dive also notes that In particular, S&P warns of a credit negative for nonprofits as patients who started in a care plan with health insurance seek to continue treatment without it.  Many hospitals already are struggling as volumes and reimbursement decline and more care shifts to [...]

2018-06-22T06:00:43-04:00June 22, 2018|hospitals|

MedPAC Issues 2018 Report to Congress

The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress. Among the findings included in the report by the Medicare Payment Advisory Commission are: Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays. Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted. MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities. MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for [...]

Helping Safety-Net Hospitals Help Their Patients

A new report published on the Health Affairs Blog describes the continuing challenges safety-net hospitals face and offers suggestions for helping them meet those challenges. The challenges, according to the report, are the virtual elimination of the Affordable Care Act’s individual health insurance mandate; the continued decline in the amount of Medicare disproportionate share hospital money (Medicare DSH) provided to safety-net hospitals; and hospital closures that shift more of the burden for caring for uninsured patients onto a smaller pool of safety-net hospitals.  The result is under-served patients and new financial risks for the hospitals that remain after some safety-net [...]

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