social determinants of health

Federal Health Policy Update for April 12

The following is the latest health policy news from the federal government for April 5-11.  Some of the language used below is taken directly from government documents. CMS – Proposed FY 2025 Medicare Inpatient Prospective Payment System Regulation Earlier this week CMS issued its proposed FY 2025 Medicare inpatient prospective payment system regulation – the rule under which it envisions paying acute-care hospitals, critical access hospitals, and long-term care hospitals for inpatient care in the coming fiscal year.  Highlights of the proposed rule include: Rate increases of 2.6 percent for acute-care and critical access hospitals and 2.8 percent for LTCHs. [...]

2024-04-12T18:35:42+00:00April 12, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, social determinants of health|
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Federal Health Policy Update for March 21

The following is the latest health policy news from the federal government for March 15-21.  Some of the language used below is taken directly from government documents. The White House The White House has announced new actions to advance women’s health research and innovation and issued an executive order in support of that objective.  The order directs executive branch agencies to integrate women’s health across the federal research portfolio; prioritize investments in women’s health research; pursue new research on women’s midlife health; and assess unmet needs to support women’s health research.  Learn more from this White House fact sheet, which [...]

2024-03-21T18:42:46+00:00March 21, 2024|Accountable Care Organization, ACO, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Uncategorized|
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Looming Medicaid Challenges

State Medicaid programs are facing significant financial challenges in the coming years. Among them:  less federal Medicaid matching money, a continued call by providers for increased payments, and a growing demand to use Medicaid to help address behavioral health challenges. In addition, proponents of investing more Medicaid money in home- and community-based services can be expected to ask state Medicaid programs to cover more services while those programs face a growing demand to use Medicaid resources to address social determinants of health such as poor housing and hunger. At the same time, large numbers of individuals continue to fall off [...]

2024-02-13T19:59:13+00:00February 15, 2024|Medicaid, Medicaid and homelessness, Medicaid and housing, social determinants of health|
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Federal Health Policy Update for January 25

The following is the latest health policy news from the federal government for January 12 - 25.  Some of the language used below is taken directly from government documents. Department of Health and Human Services – Funding Models HHS has announced a new model to test approaches for addressing the behavioral and physical health and health-related social needs of people with Medicaid and Medicare.  The goal of the Innovation in Behavioral Health Model (IBH) is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorders by connecting them with the physical, behavioral, [...]

2024-01-25T22:30:26+00:00January 25, 2024|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|
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“Drivers of Health” Drive Most Health Outcomes

A recent analysis has found that newly coined “drivers of health” are the primary drivers of health outcomes. According to a Commonwealth Fund report, Research indicates that an estimated 20 percent of health outcomes are linked to medical care; the remaining 80 percent stem from socioeconomic, environmental, and behavioral factors referred to as social drivers of health (DOH).  These factors – such as homelessness, food insecurity, and exposure to intimate partner violence – are associated with chronic illness, mental health issues, acute hospitalizations, and high health care costs and disproportionately impact communities of color. In its proposed 2023 Medicare physician [...]

2024-01-09T16:28:39+00:00January 9, 2024|Centers for Medicare & Medicaid Services, health equity, social determinants of health|
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Federal Health Policy Update for November 16

The following is the latest health policy news from the federal government for November 10-16.  Some of the language used below is taken directly from government documents. Congress This week Congress passed another continuing resolution (CR) to fund the federal government beyond Friday, when the current CR expires.  This bill establishes two separate deadlines for lawmakers to pass certain spending bills so they can avoid an omnibus bill that includes all 12 appropriations bills.  Congress must pass four of the spending bills by January 19 and the other bills by February 2.  The Labor, HHS, and Education bill, one of [...]

2023-11-16T16:58:54+00:00November 16, 2023|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, social determinants of health|
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Federal Health Policy Update for October 12

The following is the latest health policy news from the federal government for October 6-12.  Some of the language used below is taken directly from government documents. No Surprises Act CMS has reopened the federal independent dispute resolution (IDR) portal for the initiation ofnew single disputes, including single disputes involving bundled payment arrangements, but parties still cannot initiate new disputes involving air ambulance services and batched disputes for air ambulance and non-air ambulance items and services.  IDR portal functionalities related to previously initiated batched disputes also are unavailable.  Learn more about this action from this CMS announcement, which includes an [...]

2023-10-12T14:42:15+00:00October 12, 2023|COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, social determinants of health, Telehealth|
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Survey Looks at Work of Hospital Equity Officers

With more and more hospitals hiring equity officers to lead their efforts to address social determinants of health and the health care disparities that often result, a new survey examines the obstacles those health equity officials are encountering in their work. The survey and follow-up interviews of some of the respondents explore the degree of support the health equity officers believe they have from different officials throughout their hospitals and health systems, the obstacles they have encountered, the differences expressed by respondents based on the type of hospital in which they work, and the limits of pursuing their objectives strictly [...]

2023-10-12T06:00:09+00:00October 12, 2023|health equity, social determinants of health|
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Federal Health Policy Update for September 7

The following is the latest health policy news from the federal government for September 1-7.  Some of the language used below is taken directly from government documents. Congress House Republicans plan to introduce the Lower Cost, More Transparency Act for consideration before the end of the year.  This bill includes provisions passed by three committees with health care jurisdiction:  House Ways & Means, Energy & Commerce, and Education & Workforce.   Some of the bill’s provisions would: eliminate scheduled Medicaid DSH cuts for FY 2024 and FY 2025; reauthorize and extend funding for the Community Health Center program, the National Health [...]

2023-09-07T16:39:42+00:00September 7, 2023|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|
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Federal Health Policy Update for August 24

The following is the latest health policy news from the federal government for August 11-24.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services After suspending the No Surprises Act-created Independent Dispute Resolution process in the wake of a court ruling striking down a recent increase in fees for that process, CMS has established a new rate structure for initiating the adjudication of payment disagreements between providers and payers.  It explains the new rate structure in this new FAQ, which nevertheless notes that despite the creation of new rates, the Independent [...]

2023-08-24T15:32:57+00:00August 24, 2023|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, social determinants of health|
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