Uncategorized

Healthier Behavior Could Yield Sweet News

Improved behavior could save lives and money, two recent studies show. A report published by the JAMA Network found that if just one percent of Medicaid recipients stopped smoking, Medicaid would save $2.6 billion a year, with a median annual state savings of $25 million. Another study, posted by AHA Journals, concludes that improved nutrition labeling that better highlights products’ sugar content could change behavior in ways that would save more than $30 billion in health care costs over the next 20 years – and as much as nearly $60 billion if manufacturers respond to improved sugar labeling by re-engineering [...]

iqtsupport2019-04-22T10:48:20-04:00April 22, 2019|Uncategorized|

Groups Work to Create New Codes for Social Determinants

Social determinants of health could have their own ICD-10 codes if a new initiative from the American Medical Association and United Healthcare succeeds. The two are working together to develop new ICD-10 codes that would take into consideration social determinants of health such as housing and food security, access to transportation, and ability to pay for medicine. The project launches at a time when research suggests that social determinants of health can affect nearly 80 percent of health care outcomes. Learn more in the Health Analytics IT article “AMA, UnitedHealth Partner for Social Determinants ICD-10 Project.”

iqtsupport2019-04-08T06:00:59-04:00April 8, 2019|Uncategorized|

Moody’s: Challenging Times Ahead for Academic Medical Centers

Academic medical centers will struggle in the near future, according to Moody’s Investor Services. While academic medical centers still have a number of strengths – offering higher-end services, high demand for their inpatient services, and generally strong cash flow margins – they also face a number of challenges that make life more difficult for them in a value-based payment world. Among those challenges, most notably, are higher costs associated with teaching and research, higher-acuity patients, and payment pressure from insurers. Another challenge: the shrinking gap between academic medical center hospitals and others as more care is delivered on an outpatient [...]

iqtsupport2019-04-04T06:00:55-04:00April 4, 2019|Uncategorized|

Bill Would Enable Foreign-Born Docs to Work in Underserved U.S. Areas

More foreign-born, U.S.-trained doctors would be permitted to remain in the U.S. if they practice in medically underserved areas under a bill unveiled last week in Congress. Introduced with bipartisan support, the legislation would extend for two years the current “Conrad 30” program that allocates 30 slots to each state so foreign-born doctors can work in medically underserved areas under J-1 visas. The program, which already exists but will soon expire, permits such physicians to remain in the U.S. for three years after their training ends to work in underserved areas. The legislation also would establish criteria under which more [...]

iqtsupport2019-04-02T06:00:17-04:00April 2, 2019|Uncategorized|

Feds Seek More EHR in Post-Acute-Care Settings

Electronic health records may find their way into more post-acute-care settings as a result of a request for information published by the Centers for Medicare & Medicaid Services. In the RFI, CMS notes that EHR adoption has been slow in the post-acute sector and asks stakeholders what it can do to accelerate the adoption of technology designed to facilitate communication among caregivers. While EHR adoption has occurred in other areas, its use is less common in the post-acute sector, and even when used, it is used more for record-keeping than for communication among providers. EHR use and interoperability among acute-care [...]

iqtsupport2019-03-27T15:17:31-04:00March 27, 2019|Uncategorized|

A New Trend: Tying Insurance Payments to Medicare Rates?

There may be a growing movement to tie some hospital payments directly to Medicare rates. Montana started doing it two years ago, linking payments for hospital services provided to state employees to Medicare rates. Oregon will start a similar program this fall. And now, North Carolina is laying plans for a similar approach while Delaware is considering doing so. Montana is paying an average of 234 percent of Medicare hospital rates. Oregon will pay 200 percent of Medicare rates. North Carolina is talking about paying Medicare rates plus 82 percent, with extra money for rural hospitals. Such an approach could [...]

iqtsupport2019-03-25T06:00:16-04:00March 25, 2019|Uncategorized|

MedPAC Offers Recommendations on FY 2020 Rates, More

Last week the Medicare Payment Advisory Commission released its annual report to Congress. Included in this report are MedPAC’s Medicare rate recommendations for the coming year. They are: hospital inpatient rates – a two percent increase hospital outpatient rates – a two percent increase physician and other health professional services rates – no update skilled nursing facilities – no 2020 increase home health agencies – a five percent rate reduction inpatient rehabilitation facilities – a five percent rate reduction long-term-care hospital services – a two percent increase hospice services – a two percent rate reduction MedPAC also recommended that the [...]

iqtsupport2019-03-19T06:00:37-04:00March 19, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC, Uncategorized|

Surprise Balance Billing Emerges as Issue in DC

Lawmakers on both sides of the political aisle are expressing interest in addressing the problem of surprise balance billing: when insured individuals receive unexpected medical bills from providers for services for which they believe they are insured. Surprise balance bills have been a problem for years, with a number of proposals offered in the past to address the problem. Now, bipartisan support for a solution appears to be growing in Congress. In a new report, the journal Health Affairs describes the issue, outlines balance billing proposals offered in the recent past, and describes the challenges members of Congress now face [...]

iqtsupport2019-02-27T06:00:38-05:00February 27, 2019|Uncategorized|

Hospitals Continue to Employ More Docs, Buy Physician Practices

Between 2012 and 2018, the proportion of U.S. physicians employed by hospitals and health systems rose from 25 percent to 44 percent. And between 2016 and 2018, 14,000 physicians left private practice behind to work for hospitals and health systems while those hospitals and health systems purchased 8000 physician practices. One reason health systems employ physicians and purchase physician practices is enhanced reimbursement: Medicare pays more for services provided in hospital outpatient settings than in private physician offices, although Medicare has been taking steps in recent years to reduce or end this practice through the introduction of site-neutral Medicare outpatient [...]

iqtsupport2019-02-26T06:00:41-05:00February 26, 2019|Uncategorized|

New Client

DeBrunner & Associates is pleased to welcome our newest client: AristaCare Health Services, a provider of post-acute rehabilitation, memory care, and long-term-care services based in Cranford, New Jersey. Welcome!

iqtsupport2019-01-15T06:00:07-05:00January 15, 2019|Uncategorized|