Medicaid

Proposed Federal Reorganization Could Affect Health Care

Aspects of a proposed reorganization of the federal government could affect the agencies that administer key health care programs. In its 132-page Delivering Government Solutions in the 21st Century: Reform Plan and Reorganization Recommendations proposal, the White House calls for consolidating many social safety-net programs in a new Department of Health and Public Welfare. This department would retain responsibility for Medicare and Medicaid but also would assume responsibility for some food aid programs, including food stamps (now the Supplemental Food Assistance Program, or SNAP). In addition, the proposal would: consolidate all health research programs in the National Institutes of Health, [...]

iqtsupport2018-06-27T06:00:39-04:00June 27, 2018|Medicaid, Medicare|

CMS Unveils Medicaid “Scorecard”

The Centers for Medicare & Medicaid Services had introduced a new “Medicaid scorecard” that the agency says it hopes will “…increase public transparency about the programs’ administration and outcomes.” The scorecard, now posted on the Medicaid web site, presents information and data from the federal government, and reported voluntarily by the states, in three areas: state health system performance, state administrative accountability, and federal administrative accountability. The scorecard currently offers information on selected health and program indicators. Visitors can see comparative data between states and also extensive information about individual state Medicaid programs, including eligibility criteria, enrollment, quality performance, and [...]

iqtsupport2018-06-26T06:00:20-04:00June 26, 2018|Medicaid|

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 [...]

iqtsupport2018-06-25T06:00:46-04:00June 25, 2018|Affordable Care Act, health care reform, hospitals, Medicaid, Medicare, Medicare cuts|

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 [...]

iqtsupport2018-06-21T10:33:14-04:00June 21, 2018|Accountable Care Organization, ACO, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, MedPAC, post-acute care|

ACOs Moving Into Medicaid

Accountable care organizations, one of the centerpieces of recent Medicare efforts to test new ways to deliver care more effectively and at less cost, are finding their way into state Medicaid programs as well. Today, a dozen states employ Medicaid ACOs and another ten are planning to do so. Learn more about Medicaid ACOs, and how one state (Minnesota), in particular, is using them, in this Kaiser Health News report.

iqtsupport2018-06-19T06:00:58-04:00June 19, 2018|Accountable Care Organization, ACO, Medicaid|

Amid Budget Woes, States May Look to Medicaid for Savings

Budget challenges may lead some states to seek changes in their Medicaid programs aimed at saving money. Or so reports Fitch Ratings, the bond rating company. According to Fitch, health care was the biggest driver in rising state spending between 2005 and 2015 and the portion of state spending on health and social services will increase from 30.7 percent in 2015 to 38.3 percent in 2025. Among the measures states will turn to in an effort to manage rising health care costs, according to Fitch, are Medicaid work requirements, reductions in Medicaid retroactive coverage, new Medicaid premiums, and lifetime limits [...]

iqtsupport2018-06-18T06:00:04-04:00June 18, 2018|Medicaid|

Verdict: Medicaid Expansion Improved Care and Access

A new review of studies published since the Affordable Care Act’s Medicaid expansion has concluded that expansion improved care, access to care, and coverage in states that expanded their Medicaid programs. Among the improvements cited by studies are: greater use of primary care more preventive health visits more behavioral health care shorter hospital stays fewer avoidable hospital admissions reduced access problems reduced reliance on hospital ERs as a primary source of care improved monitoring and compliance rates for patients with diabetes and hypertension higher rates of screening for prostate cancer and Pap smears In addition, hospitals provided less uncompensated care [...]

iqtsupport2018-06-11T06:00:05-04:00June 11, 2018|Affordable Care Act, Medicaid|

CMS Reports on Medicaid Long-Term Care Spending

The Centers for Medicare & Medicaid Services has issued a report on FY 2016 spending for Medicaid-covered long-term services and supports. The highlights of the $167 billion in state and federal spending include: Home and community-based services have accounted for almost all Medicaid long-term services and supports growth in recent years. Home and community-based services spending increased 10 percent in FY 2016, greater than the five percent average annual growth from FY 2011 through 2015. Institutional spending remained close to the FY 2010 amount. Institutional service spending decreased two percent in FY 2016 following an average annual increase of [...]

iqtsupport2018-06-08T06:00:16-04:00June 8, 2018|Centers for Medicare & Medicaid Services, Medicaid, Medicaid long-term services and supports|

CMS Introduces Medicaid “Scorecard”

The Centers for Medicare & Medicaid Services has unveiled a “scorecard” through which interested parties will be able to monitor outcomes for state Medicaid programs, state CHIP programs, and CMS itself while also comparing the performance of states to one another. The purpose of the scorecard, according to CMS, is “to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes.” CMS also explained that The first version of the Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal [...]

iqtsupport2018-06-07T06:00:29-04:00June 7, 2018|Centers for Medicare & Medicaid Services, Medicaid|

Hospitals, Others Oppose Easing Medicaid Access Requirements

Hospital groups and other health care interest organizations have expressed strong opposition to a Centers for Medicare & Medicaid Services proposal to ease requirements that states ensure adequate access to care for their Medicaid population. Under current federal Medicaid law, states must periodically review their Medicaid provider networks to ensure that Medicaid recipients have adequate access to care. Under a March CMS proposal, that requirement would exempt states from performing such reviews if at least 85 percent of their Medicaid population is enrolled in a managed care plan and similarly exempt them from reviewing the impact on their provider networks [...]

iqtsupport2018-06-01T06:00:07-04:00June 1, 2018|Medicaid, Medicaid managed care, Medicaid regulations|