Medicare

Grassley Questions Aspects of Graduate Medical Education

Graduate medical education is the subject of inquiry in a recent letter from Senate Finance Committee chairman Charles Grassley to Health and Human Services Secretary Alex Azar. In his letter to Secretary Azar, Senator Grassley asks for information about how federal GME money is spent and how much is spent, how federal money factors into the broader financing of hospital residency programs, and how the federal government ensures that GME programs engage in best practices. The letter also questions whether the indirect benefits of operating medical education programs are factored into how much the federal government spends on medical education, [...]

iqtsupport2019-10-21T06:00:09-04:00October 21, 2019|Medicare|

No Primary Doc Shortage for Medicare Patients – at Least Not Yet

Medicare patients currently have adequate access to primary care physicians, according to the Medicare Payment Advisory Commission. But that could change in the near future, MedPAC warns. Amid long-term concerns about whether there are enough primary care doctors, a new MedPAC report found that there are even fewer primary care doctors than most people believe. MedPAC reached this conclusion after finding that approximately one out of every five doctors thought to be working as primary care physicians now labor instead as hospitalists. As a result, growth in the number of primary care physicians has been negligible during the current decade. [...]

iqtsupport2019-10-09T06:00:54-04:00October 9, 2019|Medicare, MedPAC|

Most Hospitals Hit With Medicare Readmissions Penalties

Nearly 2600 hospitals will be penalized by Medicare in FY 2020 for excessive patient readmissions under Medicare’s hospital readmissions reduction program, according to the Centers for Medicare & Medicaid Services. In all, 83 percent of hospitals covered by the program will be penalized, forfeiting up to three percent of their Medicare payments with an average penalty of 0.71 percent of those payments. The cumulative penalties for these hospitals will amount to $563 million in FY 2020. In all, 1177 hospitals will be penalized more than they were last year and 1148 will be penalized less. 56 hospitals will be assessed [...]

iqtsupport2019-10-08T06:00:52-04:00October 8, 2019|Medicare, Medicare reimbursement policy|

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 October agenda were: restructuring Medicare Part D improving Medicare payment for low-volume and isolated outpatient dialysis facilities updates to the methods used to assess the adequacy of Medicare’s payments for physicians and other health professionals population-based outcome measures: avoidable hospitalizations and emergency department visits aligning benefits and cost-sharing under a unified payment system for post-acute care policy options to modify the hospice aggregate cap MedPAC is an independent congressional agency that advises Congress on issues involving the [...]

iqtsupport2019-10-07T06:00:37-04:00October 7, 2019|Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Court Halts Medicare Site-Neutral Payment Changes

The Centers for Medicare & Medicaid Services did not have the authority to implement the site-neutral payment system for Medicare-covered outpatient services that it introduced last year, a federal court has concluded. According to the court, CMS exceeded its authority because it …was not authorized to ignore the statutory process for setting payment rates in the Outpatient Prospective Payment System and to lower payment rates only for certain services provided by certain providers. In general, hospitals oppose the movement toward site-neutral payments and independent physician groups support it. The court did not order CMS to reimburse affected physician practices for [...]

iqtsupport2019-09-19T06:00:43-04:00September 19, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, Medicare reimbursement policy|

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 September agenda were: context for Medicare payment policy the effects of Medicare Advantage “spillover” on Medicare fee-for-service spending and coding evaluation of the hospital readmissions reduction program examining the effects of competitive bidding for diabetes testing supplies and improving payment policies for DMEPOS products excluded from competitive bidding a value incentive program for post-acute-care providers Medicare indirect medical education (IME) policy, concerns, and considerations for revising MedPAC is an independent congressional agency that advises Congress on issues [...]

iqtsupport2019-09-12T09:50:13-04:00September 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Can Medicare Feed its Way Out of Some Readmissions?

Feeding some Medicare patients after they are discharged from the hospital could reduce readmissions and save taxpayers millions, a new study has concluded. According to the new Bipartisan Policy Center report Next Steps in Chronic Care: Expanding Innovative Medicare Benefits, providing a limited number of free meals to certain Medicare patients could eliminate nearly 10,000 readmissions a year and save more than $57 million. Participating patients would be those with more than one of a limited number of chronic medical conditions and the meals would be for one week only. According to the report, more than 575,000 Medicare beneficiaries would [...]

iqtsupport2019-07-31T06:00:03-04:00July 31, 2019|Medicare|

CMS Chief Criticizes Health Care Proposals

In an address to the Better Medicare Alliance 2019 Medicare Advantage Summit, Centers for Medicare & Medicaid Services Administrator Seema Verma criticized Medicare for All proposals, said Medicare “public option” proposals are no better, and called the Affordable Care Act a failure,. Verma also insisted that greater reliance on market forces would improve Medicare and Medicaid, said the 340B prescription drug program is harming the health care system, and called for a reduction of federal regulations that limit how and where people can receive care. She said reduced regulations have spurred hundreds of new plans to participate in the Medicare [...]

iqtsupport2019-07-23T10:10:59-04:00July 23, 2019|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare regulations|

HHS Launches New Quality Initiative

The evaluation, adoption, and streamlining of federal health care quality programs will be the objective of a new “quality summit” launched by the U.S. Department of Health and Human Services. In response to an executive order issued by the president, HHS has established the quality summit because, according to an HHS news release, A long-stated goal of the Trump Administration has been to shift our current government healthcare programs from paying for services and procedures to paying for better patient outcomes. We believe the best way to effect this shift is through greater transparency and a focus on quality outcomes [...]

iqtsupport2019-07-11T06:00:33-04:00July 11, 2019|Medicare|

Readmissions Higher for Medicare Advantage Patients

Medicare Advantage patients are more likely to be readmitted to the hospital for existing medical problems than participants in traditional Medicare, a new study has found. According to a report published in the Annals of Internal Medicine, Medicare Advantage patients suffering from acute myocardial infarction, congestive heart failure, and pneumonia were readmitted to hospitals because of those medical problems at slightly higher rates than patients served by traditional Medicare. Learn more from the Annals of Internal Medicine study “Hospital Readmission Rates in Medicare Advantage and Traditional Medicare: A Retrospective Population-Based Analysis” and the Healthcare Dive article “MA patients' readmission rates [...]

iqtsupport2019-07-01T06:00:15-04:00July 1, 2019|Medicare|