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|

Urban Hospitals in ACOS Better at Reducing Some Readmissions Rates

A new study has found that hospitals located in metropolitan areas that participate in accountable care organizations are doing a better job than other hospitals of reducing 30-day readmissions rates for Medicare patients who originally were discharged into skilled nursing facilities. It appears this improved performance can be attributed to two things: better discharge planning and better coordination with the skilled nursing facilities. To learn more go here to see the study “ACO-Affiliated Hospitals Reduced Rehospitalizations from Skilled Nursing Facilities Faster Than Other Hospitals.”

iqtsupport2017-01-17T06:00:47-05:00January 17, 2017|Accountable Care Organization, ACO, hospitals, Medicare|

Bundled Payments Reduce Hip, Knee Replacement Costs

Medicare’s bundled payment program for knee and hip replacements is reducing the cost of such treatments, a study has found. According to a new study in JAMA Internal Medicine, the Medicare bundled payment program, known as the Comprehensive Care for Joint Replacement program, has driven down the cost of the those joint replacements more than 20 percent or $5500 a case. Most of the savings have been derived through a significant decrease in the use of post-acute care, according to the study. This decrease occurred, moreover, at a time when Medicare spending on joint replacement rose five percent. Learn more [...]

iqtsupport2017-01-12T16:35:59-05:00January 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

Medicare Program Reduced Readmissions

Medicare’s hospital readmissions reduction program has resulted in a reduction of avoidable hospital readmissions. Or so concludes a new study published in the Annals of Internal Medicine. According to the study, which included an analysis of 15 million patient discharges beween 2000 and 2013, readmissions declined after Medicare introduced the program and the hospitals with the poorest performance prior to the program’s launch experienced the greatest improvement in reducing avoidable readmissions. To learn more, read the study “Readmission Rates After Passage of the Hospital Readmissions Reduction Program: A Pre–Post Analysis” here, on the web site of the Annals of Internal [...]

iqtsupport2017-01-06T06:00:49-05:00January 6, 2017|Medicare|

New Medicare Payments to Help With High-Need Patients

New Medicare payment practices that took effect on January 1 will improve payments to physicians who care for high-need patients in the hope that those enhanced payments will improve the care such seniors receive. Among those improved payments are: payments to physicians for the time they spend working with specialists, families, pharmacists, caregivers, and others to coordinate services for seriously ill patients improved payments for time spent coordinating seniors’ transitions between different care settings and home and connecting those patients with additional resources separate payments to perform cognitive impairment assessments payments for time physicians spend reviewing patient records and talking [...]

iqtsupport2017-01-03T06:00:14-05:00January 3, 2017|Medicare|