Medicare

Feds Looking to Bundle Medicare Post-Acute Payments?

Bring us your ideas for bundling Medicare post-acute-care payments, the head of the Center for Medicare and Medicaid Innovation recently told a gathering of hospital officials in Washington, D.C. As reported by Fierce Healthcare, CMMI director Adam Boehler told hospital officials that Now is the time to bring us ideas. We’re really in listening mode…I think there’s been a lot of intrigue and interest we’ve heard from people. So we’re gathering stakeholder input there on that and it’s a great time to give us thoughts on where we can lower costs. Learn more from the Fierce Healthcare article "CMMI's Adam [...]

iqtsupport2019-04-15T06:00:16-04:00April 15, 2019|Center for Medicare and Medicaid Innovation, CMMI, Medicare, Medicare post-acute care, post-acute care|

SNF Discharge May Affect Hospital Readmission Rates

Heart failure patients discharged from skilled nursing facilities after two days or less may be as much as four times more likely to be readmitted to a hospital than those who stay longer, according to a new analysis. The study also found that the hospital readmission rate falls by half for patients who remain in a skilled nursing facility for one to two weeks. The analysis evaluated Medicare data for heart failure patients at least 65 years old and did not adjust for their severity of illness. These findings suggest that the current emphasis on limiting patients’ time in post-acute-care [...]

iqtsupport2019-04-11T06:00:21-04:00April 11, 2019|Medicare, Medicare post-acute care, post-acute care|

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 April agenda were: Expanding the use of value-based payment in Medicare Medicare Shared Savings Program performance Redesigning the Medicare Advantage quality bonus program Increasing the accuracy and completeness of Medicare Advantage encounter data Evaluating patient functional assessment data reported by post-acute-care providers Options for slowing the growth of Medicare fee-for-service spending for emergency department services Options to increase the affordability of specialty drugs and biologics in Medicare Part D Improving payment for low-volume and isolated outpatient dialysis [...]

iqtsupport2019-04-09T06:00:04-04:00April 9, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Medicare Advantage Networks Not Narrowing

The primary care networks offered by Medicare Advantage plans are broadening and not narrowing, as some people have long feared. According to a study published in the journal Health Affairs, only 1.8 percent of Medicare Advantage plans offer narrow primary care provider networks, down from 2.7 percent in 2011. Meanwhile, the proportion of plans offering broad networks has grown from 80.1 percent in 2011 to 82.5 percent in 2015. In 2015, broad network plans enrolled 63.9 percent of Medicare Advantage participants, up from 54.1 percent in 2011. This is considered important because the proportion of Medicare beneficiaries enrolled in Medicare [...]

iqtsupport2019-04-04T13:00:55-04:00April 4, 2019|Medicare|

Mixed Verdict: Home Health Leads to More Readmissions But Lower Costs

Readmission rates are greater for patients discharged from hospitals to home health care than they are for those discharged to skilled nursing facilities but home health services cost so much less than nursing homes that home health saves money even with the higher numbers of hospital readmissions. This is one of the major findings of a new study comparing differences in outcomes for patients who are admitted to skilled nursing facilities upon discharge from the hospital to those for patients who go direct home and receive home health services. The study also found no meaningful differences in patient mortality or [...]

iqtsupport2019-03-22T06:00:57-04:00March 22, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy|

HHS Chief Derides Medicare Wage Index System

U.S. Department of Health and Human Services Secretary Alex Azar criticized the current Medicare area wage index system during a hearing of the Senate Finance Committee last week. Reminding senators that he told them last year that they need to revise the system and warning that HHS’s ability to change it is limited without legislation, Azar referred to the system as an “absurdity” as individual senators pointed out what they view to be inequities in the system that hurt hospitals in their own states. Medicare’s area wage index system adjusts Medicare payments to hospitals based on geographic differences in the [...]

iqtsupport2019-03-21T06:00:01-04:00March 21, 2019|Medicare, Medicare regulations|

MedPAC Offers Recommendations on FY 2020 Rates, More

Last week the Medicare Payment Advisory Commission released its annual report to Congress. Included in this report are MedPAC’s Medicare rate recommendations for the coming year. They are: hospital inpatient rates – a two percent increase hospital outpatient rates – a two percent increase physician and other health professional services rates – no update skilled nursing facilities – no 2020 increase home health agencies – a five percent rate reduction inpatient rehabilitation facilities – a five percent rate reduction long-term-care hospital services – a two percent increase hospice services – a two percent rate reduction MedPAC also recommended that the [...]

iqtsupport2019-03-19T06:00:37-04:00March 19, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Uncategorized|

MedPAC Discusses ED Coding Changes

Members of the Medicare Payment Advisory Commission discussed the possibility of recommending to Congress that it call for national guidelines for how hospitals code emergency department services. The change may be needed, the commissioners suggested at their March meeting, because hospitals have gravitated toward coding for higher intensity services as time passes. Such a change, if implemented, could result in less emergency department revenue for some hospitals. Learn more in the Healthcare Dive article “MedPAC eyes changes to ED coding, Part B drug pricing.”

iqtsupport2019-03-15T06:00:51-04:00March 15, 2019|Medicare, MedPAC|

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 March agenda were: two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration options for slowing the growth of Medicare fee-for-service spending for emergency department service. Medicare’s role in the supply of primary care physicians evaluating an episode-based payment system for post-acute care mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure MedPAC is an independent congressional [...]

iqtsupport2019-03-12T06:00:49-04:00March 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, post-acute care|

Stark Changes Coming to Facilitate Value Care?

At a Washington, D.C. conference, Centers for Medicare & Medicaid Services Administrator Seema Verma announced that changes coming in Stark law requirements will enable Medicare to make better use of value-based purchasing in its reimbursement system. In addition to addressing cybersecurity and electronic health record system issues, changes in the anti-self-referral law will seek to facilitate better coordination of care for Medicare patients. Verma explained the underlying rationale for the anticipated changes, noting that …in a system where we’re transitioning and trying to pay for value, where the provider is ideally taking on some risk for outcomes and cost overruns, [...]

iqtsupport2019-03-07T06:00:54-05:00March 7, 2019|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, Medicare reimbursement policy|