Medicare regulations

HHS Unveils Spring Regulatory Agenda

The U.S. Department of Health and Human Services has published a comprehensive list of the regulatory actions it plans to take in the coming months. Included on the list are regulations that have been proposed, that are being finalized, and that are currently under development. They address Medicare, Medicaid, Food and Drug Administration endeavors, medical devices, the 340B prescription drug discount program, and more. Among the policy changes contemplated through future regulations are measures to reduce regulatory burdens for hospitals, address the opioid problem, facilitate the use of non-Affordable Care Act-compliant health insurance plans, and more. Go here to see [...]

iqtsupport2018-05-14T06:00:28-04:00May 14, 2018|340b, Affordable Care Act, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Time to Raise the Bar on Preventable Hospital Readmissions?

A new report suggests that hospitals can have the greatest impact on reducing preventable readmissions within seven days of discharge and not through the 30-day mark at which they are currently judged by Medicare. According to a study published in the Annals of Internal Medicine, Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. The study, conducted at 10 academic medical centers and involving more than 800 of their patients who had been readmitted to the hospital, concludes that [...]

iqtsupport2018-05-03T06:00:37-04:00May 3, 2018|Medicare, Medicare regulations|

MedPAC Mulls Uniform Outcome Measures to Complement Unified Post-Acute Payments

In support of its proposal that Medicare adopt a unified payment system for post-acute-care services, the Medicare Payment Advisory Commission is exploring how to develop uniform outcome measures to support such a new payment system. Under the MedPAC vision, articulated at its early April public meeting, skilled nursing facilities, home health agencies, long-term-care hospitals, and inpatient rehabilitation facilities would see their outcomes quantified based on their performance on a series of quality measures. Meanwhile, there has been little congressional interest in the unified post-acute payment proposal so far. While some aspects of such a proposal could be implemented administratively, the [...]

iqtsupport2018-04-18T06:00:59-04:00April 18, 2018|Medicare, Medicare regulations, MedPAC, post-acute care|

MedPAC to Congress: Cut Payments to Freestanding Emergency Facilities

The Medicare Payment Advisory Commission has urged Congress to reduce Medicare payments to freestanding emergency departments 30 percent. The recommendation, approved by MedPAC earlier this month and to be included in its June report to Congress, notes that such facilities have a lower cost structure because they typically lack some of the equipment, personnel, and standby capabilities of hospital ERs. In making its recommendation, MedPAC also noted that freestanding ERs typically treat patients whose conditions are not as severe as hospital ERs and tend to be located in areas that already have adequate access to hospital ERs. While MedPAC’s recommendations [...]

iqtsupport2018-04-17T13:33:12-04:00April 17, 2018|hospitals, Medicare regulations, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: using payments to ensure appropriate access to and use of hospital emergency department services uniform outcome measures for post-acute care applying MedPAC’s principles for measuring quality: hospital quality incentives Medicare coverage policy and use of low-value care long-term issues confronting Medicare accountable care organizations managed care plans for dual-eligible beneficiaries While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the [...]

iqtsupport2018-04-09T06:00:21-04:00April 9, 2018|Accountable Care Organization, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

CMS Reports on Quality Measures Performance

The Centers for Medicare & Medicaid Services has published a new report detailing the progress of health care providers in meeting Medicare quality standards and improving their performance under those standards. The report, required every three years, focuses on 17 key indicators of quality in the delivery of health care as defined by 247 individual quality measures. The analysis found that: 670,000 patients improved their control of their blood pressure 510,000 fewer patients have poor control of their diabetes 12,000 fewer people died following hospitalization for a heart attack there were 70,000 fewer unplanned hospital readmissions nursing home residents suffered [...]

iqtsupport2018-03-19T06:00:39-04:00March 19, 2018|Medicare, Medicare regulations|

Readmissions Program Working; Expansion in Order?

The Medicare hospital readmissions reduction program is working, according to the Medicare Payment Advisory Commission. And it may even be worth expanding to additional medical conditions, MedPAC members believe. According to MedPAC, hospital readmissions among patients with medical conditions covered by the readmissions reduction program have declined faster than readmissions among patients with medical conditions not covered by the program, suggesting that expanding the program to additional medical conditions could lead to an even greater reduction in the number of avoidable Medicare-covered readmissions. Learn more about changes in the readmission rate since the readmissions reduction program was introduced and whether [...]

iqtsupport2018-03-07T06:00:23-05:00March 7, 2018|Medicare, Medicare regulations, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission, which advises Congress on Medicare payment issues, met last week in Washington, D.C. Among the issues on MedPAC’s agenda were: paying for sequential stays in a unified Medicare payment system for post-acute care encouraging Medicare beneficiaries to use higher-quality post-acute care providers using payment policy to ensure appropriate access to and use of hospital emergency department services the Centers for Medicare & Medicaid Services’ financial alignment demonstration for dual-eligible beneficiaries the effectiveness of the Medicare hospital readmissions reduction program population-based quality measures such as preventable admissions and home and community days Go here, to MedPAC’s [...]

iqtsupport2018-03-05T06:00:23-05:00March 5, 2018|Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

Lay Outreach Workers Reduce Readmissions

A community hospital in Kentucky has found that employing lay outreach workers to assist patients recently discharged from the hospital can significantly reduce hospital readmissions. In a research project, the hospital identified high-risk patients and, upon their discharge from the hospital, assigned lay outreach workers to help those patients with matters such as providing transportation, assisting during follow-up medical appointments, and navigating the health care system. With this help, the hospital experienced a 48 percent reduction in 30-day readmissions. While the hospital needed to spend money to employ the outreach workers, the effort reduced its likelihood of being assessed penalties [...]

iqtsupport2018-02-28T06:00:39-05:00February 28, 2018|Medicare, Medicare regulations|

Docs Not Scoring Performance Bonuses

Relatively few physicians will receive Medicare pay-for-performance bonuses under Medicare’s value-based modifier program in 2018. The question now is whether this is because of uninspiring performance or indifference to the program. Of the approximately 1.1 million clinicians who participate in Medicare, only two percent – 22,000 – will receive pay increases in 2018 based on their 2016 performance. Those raises will range from 6.6 percent to 19.9 percent. Most doctors will receive neither bonuses nor penalties. And roughly 300,000 failed to submit the data required by the program. In the past they would have been penalized for this failure but [...]

iqtsupport2018-01-25T06:00:16-05:00January 25, 2018|Medicare, Medicare regulations, MedPAC|