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|

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|