post-acute care

Federal Health Policy Update for Wednesday, May 5

The following is the latest health policy news from the federal government as of 2:45 p.m. on Wednesday, May 5.  Some of the language used below is taken directly from government documents. The White House COVID-19 The White House has posted a transcript of the May 5 press briefing by its COVID-19 response team and public health officials. Department of Health and Human Services COVID-19 HHS has created a web page for its new COVID-19 Coverage Assistance Fund through which providers can be reimbursed for the cost of administering COVID-19 vaccines to the uninsured and to those whose health insurance [...]

CMS Proposes New Medicare Payments for 2021

Medicare will change its provider payments for two types of Medicare-covered services in 2021 and has proposed changes in payments for three other Medicare-covered services in a flurry of activity over the past week. Last week the Centers for Medicare & Medicaid Services finalized new 2021 Medicare payment rates for: skilled nursing facilities hospice services inpatient psychiatric facilities In addition, this week CMS proposed new 2021 Medicare rates for: physician services outpatient and ambulatory surgical services The proposed changes in Medicare provider payments for physician services and outpatient and ambulatory surgical services are subject to a public comment period before [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment [...]

MedPAC Weighs in on Proposed Medicare Payment Changes

The Medicare Payment Advisory Commission has submitted formal comments to the Centers for Medicare & Medicaid Services in response to the latter’s publication of a proposed regulation that would govern how Medicare will pay for acute-care hospital inpatient services and long-term hospital care in the coming 2020 fiscal year. The 14-page MedPAC report addresses four aspects of the proposed Medicare payment regulation: inpatient- and outpatient drug- and device related payment proposals proposed changes in the hospital area wage index the reporting of hospitals’ uncompensated care on the Medicare cost report’s S-10 worksheet the long-term hospital prospective payment system MedPAC is [...]

Low-Income Patients More Likely to End Up in Low-Quality SNFs

Dually eligible individuals are more likely than others to find themselves in low-rated skilled nursing facilities, recent research has found. According to a study published in the Journal of Applied Gerontology, more than 50 percent of dually eligible individuals – those covered by both Medicare and Medicaid – who are admitted to skilled nursing facilities are served by facilities that have low (one or two stars) ratings under Medicare’s five-star quality rating system for nursing homes.  Overall, the dually eligible are 9.7 percentage points more likely than patients not on Medicaid to be served by lower-rated facilities. The education of [...]

2019-04-19T06:00:35-04:00April 19, 2019|Medicaid, Medicare post-acute care, post-acute care|

Feds Looking to Bundle Medicare Post-Acute Payments?

Bring us your ideas for bundling Medicare post-acute-care payments, the head of the Center for Medicare and Medicaid Innovation recently told a gathering of hospital officials in Washington, D.C. As reported by Fierce Healthcare, CMMI director Adam Boehler told hospital officials that Now is the time to bring us ideas.  We’re really in listening mode…I think there’s been a lot of intrigue and interest we’ve heard from people.  So we’re gathering stakeholder input there on that and it’s a great time to give us thoughts on where we can lower costs. Learn more from the Fierce Healthcare article "CMMI's Adam [...]

SNF Discharge May Affect Hospital Readmission Rates

Heart failure patients discharged from skilled nursing facilities after two days or less may be as much as four times more likely to be readmitted to a hospital than those who stay longer, according to a new analysis. The study also found that the hospital readmission rate falls by half for patients who remain in a skilled nursing facility for one to two weeks. The analysis evaluated Medicare data for heart failure patients at least 65 years old and did not adjust for their severity of illness. These findings suggest that the current emphasis on limiting patients’ time in post-acute-care [...]

2019-04-11T06:00:21-04:00April 11, 2019|Medicare, Medicare post-acute care, post-acute care|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s April agenda were: Expanding the use of value-based payment in Medicare Medicare Shared Savings Program performance Redesigning the Medicare Advantage quality bonus program Increasing the accuracy and completeness of Medicare Advantage encounter data Evaluating patient functional assessment data reported by post-acute-care providers Options for slowing the growth of Medicare fee-for-service spending for emergency department services Options to increase the affordability of specialty drugs and biologics in Medicare Part D Improving payment for low-volume and isolated outpatient dialysis [...]

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s March agenda were: two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration options for slowing the growth of Medicare fee-for-service spending for emergency department service. Medicare’s role in the supply of primary care physicians evaluating an episode-based payment system for post-acute care mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure MedPAC is an independent congressional [...]

Rural Nursing Homes Struggle With Challenges

Across rural parts of the country skilled nursing facilities are struggling, and growing numbers are faltering in the face of many problems. Among the challenges they face are: difficulty passing health and safety standards evolving health care policies that encourage people to remain in their homes instead of choosing to enter nursing homes growing proportions of patients covered by Medicaid the failure of Medicaid payments in many states to cover the cost of nursing home care These challenges are especially acute in rural areas.  Today, many regions have enough skilled nursing beds, at least on paper, but they are not [...]

2019-03-06T06:00:27-05:00March 6, 2019|Medicaid, post-acute care|
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