Medicare

MedPAC Discusses Post-Acute Payment Issues

At their public meeting last week, members of the Medicare Payment Advisory Commission discussed two important issues involving how Medicare pays for post-acute-care services. First, MedPAC members suggested that implementation of a new, unified, site-neutral payment system for post-acute care, mandated by the 2014 Improving Medicare Post-Acute Care Transformation Act (IMPACT), could be completed well before the legislation’s target date of 2024. Commissioners discussed the possibility of Medicare introducing such a new system, perhaps by phasing it in over a period of years, beginning in 2021. MedPAC commissioners also discussed recommending to Congress that it reduce Medicare payments for post-acute-care [...]

iqtsupport2017-03-09T06:00:15-05:00March 9, 2017|Medicare, MedPAC|

MedPAC Meets, Discusses Issues

Members of the Medicare Payment Advisory Commission met for two days last week in Washington, D.C. to discuss a number of policy issues important to health care providers. Among those issues were: a unified payment system for post-acute care hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing homes refining merit-based incentive payment systems (MIPS) and Advanced Alternative Payment Systems (A-APMs) to encourage primary care Go here to see the issue briefs and presentations used to guide MedPAC commissioners’ deliberations.

iqtsupport2017-03-06T09:50:19-05:00March 6, 2017|Medicare, MedPAC|

New Study Finds Bundled Payments Reduces Costs, Improves Care

A new study has concluded that the bundled payments programs being tested by Medicare reduce health care costs while improving the quality of care. The study covered Medicare Bundled Payment for Care Improvement (BPCI) results for the past four years and includes the Medicare hip and knee replacement bundled care program. And contrary to another recent study, this report did not find any increase in the volume of procedures during the study period. To learn more about the study’s methodology and findings, go here to read “Debunking the Argument that the Bundled Payment for Care Improvement Program (BPCI) Contributed to [...]

iqtsupport2017-02-16T16:05:06-05:00February 16, 2017|Medicare|

Group Seeks Preservation, Reform of Federal Innovation Efforts

A coalition of 35 patient, physician, and hospital groups has written to new Secretary of Health and Human Services Tom Price and asked him to continue the federal government’s exploration of new ways to deliver and pay for Medicare services but to seek certain improvements in how those efforts are undertaken. The coalition Healthcare Leaders for Accountable Innovation in Medicare asked Secretary Price for a reformed Center for Medicare and Medicaid Innovation so that it operates with … appropriately-scaled, time-limited demonstration projects, greater transparency, improved data-sharing, and broader collaboration with the private sector. The coalition also called for CMMI to [...]

iqtsupport2017-02-16T13:00:11-05:00February 16, 2017|Center for Medicare and Medicaid Innovation, CMMI, Medicare|

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such [...]

iqtsupport2017-02-15T06:00:53-05:00February 15, 2017|Accountable Care Organization, ACO, Medicare|

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services. CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries. In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.

iqtsupport2017-01-27T06:00:22-05:00January 27, 2017|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, Medicaid, Medicare|

VBP No Boon for Patients

Medicare efforts to use value-based purchasing to foster improvement in the quality of hospital care has not improved the quality of patients’ experience in those hospitals, according to a new study. Addressing the quality of patients’ experience in the hospital, the Health Affairs study “Patient Hospital Experience Improved Modestly, But No Evidence Medicare Incentives Promoted Meaningful Gains” concluded about Medicare’s value-based purchasing efforts that While certain subsets of hospitals improved more than others, we found no evidence that the program has had a beneficial effect. See the study here.

iqtsupport2017-01-24T06:00:29-05:00January 24, 2017|Medicare|

MedPAC: Small Pay Raise for Hospital Inpatient, Outpatient Services

The independent agency that advises Congress on Medicare payment matters has recommended modest increases in Medicare payments for hospital inpatient and outpatient services in FY 2018. The Medicare Payment Advisory Commission voted in support of a market basket increase of approximately 1.85 percent for Medicare outpatient and inpatient services in FY 2018. MedPAC also voted to recommend a 0.5 percent increase in payments to physicians but no increase for ambulatory surgery centers. MedPAC will formally submit its recommendations to Congress in March. Learn more about these and other MedPAC recommendations for changes in Medicare provider reimbursement in this article on [...]

iqtsupport2017-01-20T06:00:18-05:00January 20, 2017|Medicare, MedPAC|

MedPAC Meets

Last week the independent agency that advises Congress on Medicare payment issues met for two days in Washington, D.C. Among the issues on the agenda of the Medicare Payment Advisory Commission were: payments for hospital inpatient and outpatient services, ambulatory surgery centers, dialysis facilities, and hospice care payments for post-acute-care providers a unified payment system for post-acute-care services Medicare Advantage Medicare Part B and Part D payments Medicare-covered primary care services implementation of the Medicare Access and CHIP Reauthorization Act of 2015 Go here for links to the issue briefs and presentations used at the MedPAC meeting and for a [...]

iqtsupport2017-01-19T06:00:38-05:00January 19, 2017|hospitals, Medicare, Medicare regulations, MedPAC|

ACOs Serving Low-Income and Minority Patients Underperform

Accountable care organizations that serve large numbers of minority patients score lower on Medicare quality measures than other ACOs, a new study has found. According to the study, ACOs serving larger numbers of minority patients perform worse than other ACOs on 25 of 44 Medicare performance measures – and that performance does not improve over time. The study also pointed out that the minority patients served by ACOs are generally poorer and sicker than other ACO participants. Learn more about these and other findings in the report “ACOs Serving High Proportions of Racial and Ethnic Minorities Lag in Quality Performance,” [...]

iqtsupport2017-01-18T06:00:56-05:00January 18, 2017|Accountable Care Organization, ACO, Medicare|