Medicare

Study Raises Questions About Progress Toward Reducing Readmissions

A new study suggests that the reduction in hospital readmissions of recent years may not be as meaningful a reflection of improved quality of care as some observers believe. According to a new study published in the New England Journal of Medicine, at the same time that hospitals have reduced their readmissions of Medicare patients in response to penalties imposed through Medicare’s hospital readmissions reduction program, the rate of readmission of patients who are hospitalized for observation stays after visiting the emergency room has increased 35 percent. This increase in readmissions for observation stay patients comes at a time, moreover, [...]

iqtsupport2018-06-05T10:03:22-04:00June 5, 2018|Medicare|

Medicare Model Program Improved Care But Didn’t Lower Costs

A federal program that tested a new approach to the delivery of Medicare services to high-risk patients delivered on its promise to improve the quality of care for patients but did not reduce the cost of caring for those patients. The Centers for Medicare & Medicaid Services’ Comprehensive Primary Care Initiative improved access to care for patients in more than 500 participating medical practices and reduced their ER visits two percent but did not reduce Medicare’s cost for caring for these patients. After several years in effect the program, which features enhanced care management for high-risk patients, improved coordination of [...]

iqtsupport2018-05-30T06:00:04-04:00May 30, 2018|Medicare|

HHS Unveils Spring Regulatory Agenda

The U.S. Department of Health and Human Services has published a comprehensive list of the regulatory actions it plans to take in the coming months. Included on the list are regulations that have been proposed, that are being finalized, and that are currently under development. They address Medicare, Medicaid, Food and Drug Administration endeavors, medical devices, the 340B prescription drug discount program, and more. Among the policy changes contemplated through future regulations are measures to reduce regulatory burdens for hospitals, address the opioid problem, facilitate the use of non-Affordable Care Act-compliant health insurance plans, and more. Go here to see [...]

iqtsupport2018-05-14T06:00:28-04:00May 14, 2018|340b, Affordable Care Act, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Time to Raise the Bar on Preventable Hospital Readmissions?

A new report suggests that hospitals can have the greatest impact on reducing preventable readmissions within seven days of discharge and not through the 30-day mark at which they are currently judged by Medicare. According to a study published in the Annals of Internal Medicine, Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. The study, conducted at 10 academic medical centers and involving more than 800 of their patients who had been readmitted to the hospital, concludes that [...]

iqtsupport2018-05-03T06:00:37-04:00May 3, 2018|Medicare, Medicare regulations|

CMS Mulls Direct Provider Contracting for Medicare

The Centers for Medicare & Medicaid Services is seeking public input on a proposal to permit Medicare beneficiaries to enter into direct contracts with primary care and multi-specialty providers. According to CMS, A DPC [direct provider contracting] model would aim to enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have actively chosen this type of care model. The request for information, issued earlier this week, seeks public input on experience with direct provider contracting and asks interested parties to describe how Medicare might structure such [...]

iqtsupport2018-04-27T09:17:46-04:00April 27, 2018|Centers for Medicare & Medicaid Services, Medicare|

MedPAC Mulls Uniform Outcome Measures to Complement Unified Post-Acute Payments

In support of its proposal that Medicare adopt a unified payment system for post-acute-care services, the Medicare Payment Advisory Commission is exploring how to develop uniform outcome measures to support such a new payment system. Under the MedPAC vision, articulated at its early April public meeting, skilled nursing facilities, home health agencies, long-term-care hospitals, and inpatient rehabilitation facilities would see their outcomes quantified based on their performance on a series of quality measures. Meanwhile, there has been little congressional interest in the unified post-acute payment proposal so far. While some aspects of such a proposal could be implemented administratively, the [...]

iqtsupport2018-04-18T06:00:59-04:00April 18, 2018|Medicare, Medicare regulations, MedPAC, post-acute care|

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: using payments to ensure appropriate access to and use of hospital emergency department services uniform outcome measures for post-acute care applying MedPAC’s principles for measuring quality: hospital quality incentives Medicare coverage policy and use of low-value care long-term issues confronting Medicare accountable care organizations managed care plans for dual-eligible beneficiaries While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the [...]

iqtsupport2018-04-09T06:00:21-04:00April 9, 2018|Accountable Care Organization, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

MedPAC Issues 2018 Report to Congress

The Medicare Payment Advisory Commission has issued its 2018 report and recommendations to Congress. The report includes MedPAC’s recommendations for next year’s Medicare fee-for-service payments; a review of the Medicare Advantage and Medicare Part D programs, with recommendations; and a report telehealth required by the 21st Century Cures Act. For Medicare fee-for-service rates, MedPAC proposes: the inpatient and outpatient rate increases, physician and other health professional rate increases, and outpatient dialysis increase included under current law no increase for ambulatory surgical centers, long-term-care hospitals, and hospice providers no rate increase for skilled nursing facilities a five percent reduction of payments [...]

iqtsupport2018-03-21T06:00:04-04:00March 21, 2018|Medicare, MedPAC|

CMS Reports on Quality Measures Performance

The Centers for Medicare & Medicaid Services has published a new report detailing the progress of health care providers in meeting Medicare quality standards and improving their performance under those standards. The report, required every three years, focuses on 17 key indicators of quality in the delivery of health care as defined by 247 individual quality measures. The analysis found that: 670,000 patients improved their control of their blood pressure 510,000 fewer patients have poor control of their diabetes 12,000 fewer people died following hospitalization for a heart attack there were 70,000 fewer unplanned hospital readmissions nursing home residents suffered [...]

iqtsupport2018-03-19T06:00:39-04:00March 19, 2018|Medicare, Medicare regulations|

New Report Details Key Health Care Provisions in February Budget Bill

The Congressional Research Service has published a new report describing the health care-related provisions in the Bipartisan Budget Act of 2018 that Congress passed last month to fund the federal government. A major part of that law was the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, and the new report includes descriptions of the Medicare, Medicaid, CHIP, public health, and other health care aspects of the law. Go here to find the Congressional Research Service report Bipartisan Budget Act of 2018 (P.L. 115-123): Brief Summary of Division E—The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act.

iqtsupport2018-03-14T06:00:47-04:00March 14, 2018|Medicaid, Medicare|