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|

Number of Uninsured Children Rises

For the first time since 2008, the number of uninsured children in the U.S. increased in 2017, according to a new report from the Georgetown University Health Policy Institute. While the total increase in the number of uninsured children is small – just 276,000 – 2017 marked the first time in nearly a decade that the number of uninsured children has risen. For the year, 3.9 million were uninsured, up from 3.6 million in 2016. Passage of the Affordable Care Act and extension of the Children’s Health Insurance Program (CHIP) have contributed to declines in the number of uninsured children. [...]

iqtsupport2018-11-30T06:00:36-05:00November 30, 2018|Uncategorized|

The Changing of the Congressional Health Care Guard

Last week’s elections will bring to office in January a new majority party in the House and changes in the Senate as well. Changes in leadership are coming in all of the House committees with jurisdiction over health care matters: Energy and Commerce, Ways and Means, Appropriations, and Oversight and Government Reform. New leadership may be coming to the Senate Finance Committee as well. Kaiser Health News has published a look at the relevant committees, their likely new leaders, and the priorities of those new leaders. Find that report here.

iqtsupport2018-11-13T06:00:56-05:00November 13, 2018|Uncategorized|

North Carolina Proposal Could be Precedent-Setting

Under a new proposal by North Carolina’s state treasurer, health care for state employees could be reimbursed based on a percentage of Medicare rates. North Carolina’s State Health Plan insures more than 700,000 state employees and public school teachers, and under the proposal, doctors, hospitals, and other providers that participate in the plan would agree to accept an as-yet unstated percentage of Medicare rates. The state treasurer estimates that this approach would save the State Health Plan $300 million a year and save plan participants another $60 million a year. According to North Carolina Health News, the state’s hospitals are [...]

iqtsupport2018-11-09T06:00:39-05:00November 9, 2018|Uncategorized|

Ways and Means Releases Red Tape Report

The House Ways and Means Committee has released a report detailing its efforts to date to reduce red tape in the delivery of health care and to present steps it might take in the future to continue with that process. In the first stage of its red tape project, Ways and Means solicited stakeholder input and heard from nearly 300 stakeholder groups. Next, it hosted roundtable discussions with various groups to review the issues they raised. Now, following publication of its report, the committee plans to work in consultation with the administration to advance legislation to address some of the [...]

iqtsupport2018-09-05T06:00:30-04:00September 5, 2018|Uncategorized|

Growing Number of Hospitals on the Critical List

Eight percent of American hospitals – 450 of them – are at risk of closing in the coming years and another 10 percent, or 600 hospitals, are considered “weak” according to a new analysis performed by Morgan Stanley. The signs of these problems include sinking margins, declining occupancy and revenue, and government and insurer policies that enable patients to receive certain services at facilities other than hospitals, as they did in the past. The largest concentrations of at-risk hospitals can be found in Texas, Oklahoma, Louisiana, Kansas, Tennessee, and Pennsylvania. Learn more about the Morgan Stanley analysis in this Bloomberg [...]

iqtsupport2018-08-29T06:00:43-04:00August 29, 2018|Uncategorized|