Medicare

New Book Addresses Social Risk Factors in Medicare

In the new book Accounting for Social Risk Factors in Medicare Payment, the National Academies of Sciences, Engineering, and Medicine addresses the question of what social risk factors might be worth considering in Medicare value-based payment programs and how those risk factors might be reflected in value-based payments. The book, the culmination of a five-part NASEM process, focuses on five social risk factors: socio-economic position race, ethnicity, and cultural context gender social relationships residential and community context Addressing such factors in Medicare value-based payments, the book finds, can help achieve four important goals: reduce disparities in access, quality, and outcomes [...]

iqtsupport2017-05-24T11:47:42-04:00May 24, 2017|Medicare|

MedPAC Testifies Before Congress

Last week Mark Miller, executive director of the Medicare Payment Advisory Commission, testified before the House Ways and Means Committee’s Health Subcommittee. In his testimony, Miller summarized and explained some of the key points MedPAC made in its March report to Congress, including: why MedPAC believes most post-acute-care payments are too high; why Medicare needs to reduce the incentives for hospitals and doctors to deliver more services; why it recommended no FY 2018 payment increases for long-term acute-care hospitals, ambulatory surgical centers, and skilled nursing facilities and reductions of payments for home health care providers and inpatient rehabilitation facilities; why [...]

iqtsupport2017-05-22T06:00:12-04:00May 22, 2017|hospitals, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

Medicare’s Costs Can Be High for Low-Income Beneficiaries

Despite enjoying Medicare coverage, low-income seniors can still spend a significant portion of their limited income on costs Medicare does not cover. According to a new study published by the Commonwealth Fund, more than 25 percent of Medicare beneficiaries spend at least 20 percent of their income on health care – on things like premiums, cost-sharing, prescriptions, and dental and vision care, long-term care, and other services not covered by the federal program. These costs pose a problem for many because nearly half of all Medicare participants have incomes below the federal poverty level, which is slightly less than $24,000 [...]

iqtsupport2017-05-17T06:00:03-04:00May 17, 2017|Medicare|

Incentive Program Reduces Post-Acute-Care Costs

Participants in the Medicare Shared Savings Program are reducing Medicare expenditures for post-acute-care. So reports a new study published in the journal JAMA Internal Medicine. According to the study, the discharge of fewer patients into skilled nursing facilities and shorter stays for those who do spend time in such facilities reduced Medicare post-acute care spending for patients participating in the shared savings program by nine percent in 2014. Learn more about the study in this article in this McKnight’s Long-Term Care News article or go here to see the JAMA Internal Medicine study “Changes in Postacute Care in the Medicare [...]

iqtsupport2017-04-26T06:00:52-04:00April 26, 2017|Medicare|

New MACPAC Study Evaluates Medicaid, Medicare Payments

Medicaid payments to hospitals are comparable to or even higher than Medicare payments. Or at least they are once supplemental Medicaid payments are included. So concludes a new study by the Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises the states, Congress, and the administration on Medicaid and CHIP payment and access issues. In what MACPAC bills as the “first-ever study to construct a state-level payment index to compare fee-for-service inpatient hospital payments across states and to benchmark Medicaid payments to other payers such as Medicare,” the study found that Across states, base Medicaid [...]

iqtsupport2017-04-17T06:00:40-04:00April 17, 2017|MACPAC, Medicaid, Medicare|

MedPAC: New Medicare Post-Acute Payment System Needed – Soon

Medicare should implement a unified, site-neutral payment system for post-acute care as soon as 2021, the Medicare Payment Advisory Commission has decided. Current efforts to develop and implement such a system should be accelerated, Congress’s advisors on Medicare payment issues decided. While MedPAC’s recommendations are not binding, they are highly respected by Congress and federal regulators and often find their way into new public policy. MedPAC will present its latest recommendations to Congress in June. For more information about MedPAC’s position on post-acute-care payments, see this article in McKnight’s Long-Term Care News.

iqtsupport2017-04-13T06:00:37-04:00April 13, 2017|Medicare, Medicare post-acute care, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Committee met last week in Washington, D.C. On the MedPAC agenda were the following issues: Part B drug payment policy issues using premium support in Medicare implementing a unified payment system for post-acute care an overview of the medical device industry regional variation in Medicare Part A, Part B, and Part D spending and service use measuring low-value care in Medicare payment and plan incentives in Part D the role of Medicare policy in provider consolidation Find the issue briefs and presentations that supported MedPAC commissioners’ discussion of these issues here and find a transcript of [...]

iqtsupport2017-04-12T11:49:58-04:00April 12, 2017|Medicare, MedPAC|

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial [...]

iqtsupport2017-03-29T06:00:30-04:00March 29, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicare|

Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well: replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid. Among [...]

iqtsupport2017-03-29T06:00:07-04:00March 29, 2017|Medicaid, Medicare|

MedPAC Offers Provider Rate Recommendations for FY 2018

The Medicare Payment Advisory Commission has submitted its annual Medicare payment rate recommendations to Congress. The recommendations, required by law, include: rate increases as required by current law for hospital inpatient payments, hospital outpatient payments, physicians, other health professional services, and outpatient dialysis payments; no updates for ambulatory surgical centers, skilled nursing facilities, long-term-care hospitals, and hospices; and five percent rate reductions for home health agencies and inpatient rehabilitation facilities. MedPAC continued its past practice of recommending reform of the manner in which Medicare pays for post-acute-care services, maintaining that the unified payment system it has proposed would save $30 [...]

iqtsupport2017-03-22T06:00:14-04:00March 22, 2017|Medicare, MedPAC|