Medicare

Study Finds Communication Woes That Pose Risks for the Elderly

Inadequate communication between doctors and home health providers unnecessarily puts elderly patients at risk, a new study has found. At the heart of this problem are lack of access to physician information for home health workers, challenges home providers face when seeking to order new services, lack of accountability among physicians, and poor transitions between hospitalists and patients’ primary care doctors. Learn more about these challenges and ways to address them in the study “’Connecting the Dots’: A Qualitative Study of Home Health Nurse Perspectives on Coordinating Care for Recently Discharged Patients,” which can be found here, in the Journal [...]

iqtsupport2017-07-27T06:00:59-04:00July 27, 2017|Medicare|

GAO Looks at Use of Telehealth in Medicare, Medicaid

The U.S. Government Accountability Office has examined the use of telehealth services in the Medicare and Medicaid programs. In a study that looked at current Medicare practices, sampled Medicaid practices in six states, and consulted selected provider, payment, and patient associations, the GAO evaluated the extent to which telehealth is used in Medicare and Medicaid today, factors that affect the use of telehealth in Medicare, and the degree to which new payment and delivery models might affect future telehealth utilization in Medicare. The report does not offer recommendations. The GAO released its findings in a new report titled Telehealth: Use [...]

iqtsupport2017-07-26T06:00:39-04:00July 26, 2017|Medicaid, Medicare|

CMS to Consider Model Behavioral Health Payment and Delivery Program

The Center for Medicare and Medicaid Innovation has invited interested parties to weigh in on the possibility of creating a new Medicare model program for behavioral health care delivery and payment. According to a notice published in the Federal Register, The Innovation Center is interested in designing a potential payment or service delivery model to improve health care quality and access, while lowering the cost of care for Medicare, Medicaid, or CHIP beneficiaries with behavioral health conditions. The model may include participation by other payers, qualify as an Advanced Alternative Payment Model (APM), improve health care provider participation in telehealth [...]

iqtsupport2017-07-25T06:00:10-04:00July 25, 2017|Center for Medicare and Medicaid Innovation, CMMI, Medicare|

Congress Looks at 340B Program

Last week the House Energy and Commerce Committee took a look at the 340B prescription drug discount program, which requires pharmaceutical companies to sell discounted drugs for outpatient use to hospitals that care for especially large numbers of low-income patients. The previous week, the Centers for Medicare & Medicaid Services issued a proposed Medicare regulation calling for significant reductions in Medicare payments for such drugs. The hearing touched on the CMS proposal to reduce Medicare payments for 340B drugs, the high prices of prescription drugs, the 340B program’s growth over the years, the possibility that the program is being abused [...]

iqtsupport2017-07-24T06:00:44-04:00July 24, 2017|Medicare, Medicare regulations|

Mortality Doesn’t Go Up When Readmissions Come Down

The emphasis in recent years on reducing hospital readmissions has not resulted in an increase in post-discharge deaths among Medicare patients. Or so concludes a new study published in JAMA. Looking at outcomes associated with Medicare’s hospital readmissions reduction program, the study “Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge” found that … of more than 5 million Medicare fee-for-service hospitalizations for heart failure, acute myocardial infarction, and pneumonia from 2008 to 2014, reductions in hospital 30-day readmission rates were weakly but significantly correlated with reductions in 30-day mortality rates after hospital discharge. Learn more about [...]

iqtsupport2017-07-19T15:21:29-04:00July 19, 2017|Medicare|

CMS Seeks to Track Post-ASC Hospitalizations

The Centers for Medicare & Medicaid Services has announced a new initiative to track hospital admissions among Medicare patients who have recently been served at an ambulatory surgical center. The new measure would become part of the agency’s broader quality reporting efforts. The federal government has a large stake in the performance of ambulatory surgical centers: it spends $4 billion a year on care for more than three million Medicare patients at such facilities. Learn more about the project CMS calls “Development of a Facility-Level Quality Measure of Unplanned Hospital Visits after General Surgery Procedures Performed at Ambulatory Surgical Centers” [...]

iqtsupport2017-07-14T06:00:56-04:00July 14, 2017|Medicaid regulations, Medicare|

HHS Needs to Do More on Physician Training

The federal government needs to do more to ensure an adequate supply of primary care physicians and their deployment in non-urban areas outside of the northeastern U.S. Or so concludes a new study performed by the U.S. Governor Accountability Office. According to the GAO report, efforts by the U.S. Department of Health and Human Services have resulted in progress toward meeting both of these goals – but not enough progress. With the federal government spending $15 billion on graduate medical education, GAO believes, HHS can and should do more to ensure an adequate supply of primary care physicians throughout the [...]

iqtsupport2017-06-28T06:00:41-04:00June 28, 2017|Medicare|

Elderly Patients Return to Hospitals After Observation Stay

More than one in five Medicare patients who have observation stays in the hospital return to that hospital within 30 days, according to a new study published in The BMJ. Among those returning to the hospital, 8.4 percent return to the emergency room, 2.9 percent have another observation stay visit, and 11.2 percent are admitted to the hospital. Another 1.8 percent pass away within 30 days. The numbers are similar for Medicare patients who only visit the emergency room. Learn more about the study’s findings and its implications for improving post-discharge care in The BMJ article “Outcomes after observation stays [...]

iqtsupport2017-06-26T06:00:39-04:00June 26, 2017|Medicare|

MedPAC Delivers Annual Report to Congress

The Medicare Payment Advisory Commission has issued its annual report and recommendations to Congress. The major issues addressed in the report include: implementing a unified payment system for post-acute care reforming Medicare payment for drugs under Part B redesigning the merit-based incentive payment system (MIPS) and strengthening advanced alternative payment models using premium support for Medicare the relationship between clinician services and other Medicare services payments from drug and device manufacturers to physicians and teaching hospitals in 2015 the medical device industry stand-alone emergency departments hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities the [...]

iqtsupport2017-06-21T06:00:29-04:00June 21, 2017|Medicare, Medicare post-acute care, MedPAC|

Medicare Delays New and Expanded Bundled Payment Programs

Medicare has delayed the launch of its mandatory Medicare Cardiac Rehabilitation Incentive Payment program until January 1. It also has delayed the expansion of its Comprehensive Care for Joint Replacement program through a new Surgical Hip and Femur Fracture Treatment program. Originally scheduled to begin on May 20 and then pushed back to July 1, now it, too, will not begin until January 1. Medicare’s Acute Myocardial Infarction program and Coronary Artery Bypass Graft program will still begin on July 1. For further information, see this Federal Register notice announcing the delays.

iqtsupport2017-05-26T06:00:29-04:00May 26, 2017|Medicare|