Moody’s downgraded more non-profit hospital credit ratings than it raised in 2017. The credit-rating company attributed the downgrades to nursing shortages in some markets and rising pharmaceutical and supplies costs. Nearly a third of the downgrades were in just two states: Ohio and Pennsylvania. Learn more about Moody’s 2017 downgrades and upgrades in this report from Becker’s Hospital Review.
Safety-net hospitals across the country face a new challenge: adjusting to several cuts in the supplemental payments they receive from the federal government to help them serve the low-income residents of the communities in which they are located. First there is a $2 billion cut in Medicaid disproportionate share hospital payments (Medicaid DSH). These are payments made to hospitals that serve especially large numbers of low-income patients. These payments help safety-net hospitals with the unreimbursed expenses they incur caring for such patients. This cut, mandated by the Affordable Care Act but twice delayed by Congress, took effect on January 1. [...]
Hospitals in states that took advantage of the Affordable Care Act to expand their Medicaid programs are six times less likely to close than hospitals in non-expansion states. And the impact of Medicaid expansion is even more beneficial for hospitals that serve rural communities. These are among the new findings in a new study that examines the effect of Medicaid expansion on hospital finances and hospital closures. Among those findings, We found that the ACA’s Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of [...]
The Medicare Payment Advisory Commission met in Washington, D.C. last week. Among the issues on the agenda of the independent agency that advises Congress on Medicare payment issues were: payment adequacy for physicians and other health professional services An alternative to the merit-based incentive payment system (MIPS) payment adequacy for hospital inpatient and outpatient services payment adequacy for ambulatory surgical center services payment adequacy and improving the equity of payments for skilled nursing facility services payment adequacy for inpatient rehabilitation services payment adequacy for long-term-care hospital services payment adequacy for home health services payment adequacy for outpatient dialysis services payment [...]
The uninsured do not use emergency rooms more than the insured. And the expansion of health insurance coverage increases rather than decreases ER use. So concludes the new Health Affairs study “The Uninsured Do Not Use the Emergency Department More – They Use Other Care Less.” Find the study here.
Are hospitals using the savings generated by their participation in the section 340B prescription drug discount program to help their low-income and uninsured patients? That’s what the House Energy and Commerce Committee’s Health Subcommittee is asking. Earlier this year the committee requested such information from the Health Services and Resources Administration, which runs the 340B program, and now it’s asking hospitals as well. Specifically, the subcommittee sent five-page letters to 19 providers that participate in the 340B program asking them about: the quantity of 340B-purchased drugs they dispense to Medicare beneficiaries, Medicaid beneficiaries, and those with private insurance the quantity [...]
The Centers for Medicare & Medicaid Services has taken a step toward answering that question in a new, 12-page guidance document that seeks to define whether a facility qualifies as a hospital under section 1861(e) of the Social Security Act. At the heart of the question is that law’s definition of a hospital, which includes that it is “primarily engaged” in caring for inpatients. CMS’s guidance outlines parameters for determining whether a hospital meets this standard. Find that CMS document here.
The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [...]
Far fewer hospital emergency room visits are for medical problems better addressed in other settings, according to a new study. In a review of six years worth of data encompassing 424 million ER visits, researchers found that only 3.3 percent of those visits were truly “avoidable,” with the avoidable visits mostly involving problems ERs are not equipped to address, such as dental and mental health issues. This finding flies in the face of the conventional wisdom that people turn too quickly to hospital ERs for routine medical problems or use ERs because they lack access to more appropriate care. Learn [...]
Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [...]