Medicare

Hospitals Improving on Medicare Value-Based Measures

U.S. hospitals continue to improve their performance under Medicare’s value-based purchasing program. In FY 2018, 57 percent of hospitals will receive Medicare bonuses from the program, up from 55 percent in FY 2017. Bonuses are generally small but for some hospitals will be more than three percent. Roughly half of all hospitals will experience changes in their Medicare base rates. The worst performers will see their payments decline 1.65 percent. In FY 2018, hospitals that succeed in the program will share $1.9 billion in bonus payments. Funding for those payments in this budget-neutral program comes from CMS withholding two percent [...]

iqtsupport2017-11-10T06:00:07-05:00November 10, 2017|Medicaid regulations, Medicare|

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C. Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were: the merit-based incentive payment system a unified payment system for post-acute care telehealth a redesign of Medicare’s hospital value incentive program Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site.

iqtsupport2017-10-11T06:00:23-04:00October 11, 2017|Medicare, MedPAC|

House Committee to Hold 340B Hearing

The House Energy and Commerce Committee’s oversight subcommittee will hold a hearing on Wednesday about the 340B Drug Pricing Program. At the hearing, titled “Examining How Covered Entities Utilize the 340B Drug Pricing Program,” the subcommittee hopes …to hear directly from entities participating in the program to get a better understanding of how the program is used, including how much money is saved, the types of drugs purchased and prescribed within the program, how entities track their savings, and how those savings are used to improve patient care. Learn more about the hearing and the witness list from the subcommittee’s [...]

iqtsupport2017-10-10T06:00:39-04:00October 10, 2017|Medicare|

340B Changes Would Hurt Hospital Margins

Proposed changes in the federal section 340B prescription drug discount program would hurt hospital margins. So says Moody’s Investors Service, the credit rating agency. According to Moody’s, the margins of non-profit hospitals are already under pressure because revenue increases are not keeping pace with prescription drug costs. Reductions of payments under the 340B program recently proposed by the Centers for Medicare & Medicaid Services would make a challenging situation worse, Moody’s speculates. Under the 340B program, eligible hospitals purchase prescription drugs at a discount, supply them to eligible outpatients, and use the savings they gain to provide additional services and [...]

iqtsupport2017-10-09T06:00:51-04:00October 9, 2017|Medicare, Medicare cuts, Medicare regulations|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met last week in Washington, D.C. Among the issues they discussed during their two days of meetings were Medicare coverage policy, Medicare coverage of telehealth services, pharmacy benefit managers and specialty pharmacies, and physician supervision requirements in critical access and small rural hospitals. Go here to see the issue briefs and presentations that were discussed during the meeting.

iqtsupport2017-09-13T06:00:10-04:00September 13, 2017|Medicare, MedPAC|

MedPAC Comments on Proposed Physician Fee Schedule

The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018. Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program. See CMS’s comment letter here.

iqtsupport2017-09-12T06:00:52-04:00September 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, MedPAC|

Medicare ACOs Showing Promise

Medicare’s Shared Savings Program and its accountable care organizations are showing promise as a means of reducing Medicare spending and improving the quality or care. Or so concludes the U.S. Department of Health and Human Services’ Office of the Inspector General. According to a new OIG report, Over the first 3 years of the program, 428 participating Shared Savings Program ACOs served 9.7 million beneficiaries. During that time, most of these ACOs reduced Medicare spending compared to their benchmarks, achieving a net spending reduction of nearly $1 billion. At the same time, ACOs generally improved the quality of care they [...]

iqtsupport2017-09-07T06:00:13-04:00September 7, 2017|Accountable Care Organization, ACO, Medicare|

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation [...]

iqtsupport2017-09-01T06:00:14-04:00September 1, 2017|Medicare, Medicare regulations|

Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices. So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program. The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient. Learn more [...]

iqtsupport2017-08-03T09:05:51-04:00August 3, 2017|Medicare|

Ways and Means Seeks to Cut Medicare Red Tape

The House Ways and Means Committee’s Health Subcommittee has launched a new initiative to attempt to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery. The subcommittee describes its “Medicare Red Tape Relief Project” as …a new initiative to deliver relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries. In support of this initiative, the committee has announced a three-part approach in which it will seek feedback from stakeholders, host roundtables with stakeholders across the country, [...]

iqtsupport2017-07-27T13:00:59-04:00July 27, 2017|Medicare, Medicare regulations|