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New Policy Threatens Provider Payments in Missouri

Health care providers that fail to join the provider networks of Missouri Medicaid managed care plans will see their Medicaid payments cut 10 percent by the state under a new state policy. The purpose of the policy, according to the state, is to encourage hospitals and physicians to join the provider networks of three managed care plans that serve more than 700,000 residents of the state. Providers, on the other hand, say this policy will discourage them from serving Medicaid patients at all and will detract from their ability to negotiate reasonable rates with the state’s three Medicaid managed care [...]

iqtsupport2018-07-11T06:00:15-04:00July 11, 2018|Uncategorized|

Review: Telehealth Shows Mixed Results

A federal review of the use of telehealth services suggests that such services may be appear useful in helping to improve care and reduce costs under certain conditions but are less useful in others. According to a draft currently under review by the Agency for Health Care Research and Quality, Remote intensive care unit (ICU) consultations likely reduce ICU mortality and ICU length of stay (LOS); specialty telehealth consultations likely reduce the time patients spend in the emergency department; and remote consultations for outpatient care likely improve access and a range of clinical outcomes (moderate strength of evidence in favor [...]

iqtsupport2018-06-06T06:00:29-04:00June 6, 2018|Uncategorized|

CMS Unveils Rural Health Strategy

The Centers for Medicare & Medicaid Services had introduced what it calls its “first rural health strategy.” According to the agency, the purpose of the strategy is …to provide a proactive approach on healthcare issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable healthcare. “For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” said CMS Administrator Seema Verma. “The Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and [...]

iqtsupport2018-05-10T06:00:28-04:00May 10, 2018|Uncategorized|

Short-Term Plans May Short-Change Purchasers

The short-term health insurance plans that the administration proposes making more available to consumers as an alternative to comprehensive health insurance that meets Affordable Care Act coverage requirements may leave consumers with greater out-of-pocket costs and less coverage for some critical services. According to a Kaiser Family Foundation review of available short-term, limited duration plans in 10 markets across the country, those plans: often do not cover mental health and substance abuse services and outpatient prescription drugs may turn down individuals or charge them higher premiums based on age, gender, or health status, including pre-existing conditions require greater cost-sharing by [...]

iqtsupport2018-04-25T06:00:12-04:00April 25, 2018|Uncategorized|

Eat! You’ll Feel Better

And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food: some received general meal deliveries while others received food tailored to their individual medical conditions. The purpose: address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants in the medically tailored meal program also had fewer inpatient [...]

iqtsupport2018-04-04T06:00:52-04:00April 4, 2018|Uncategorized|

Tackling Social Determinants of Health

The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients. A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations: Developing the business case,” seeks to serve as a manual for providers seeking to move into this relatively new territory. The report takes providers through [...]

iqtsupport2018-03-28T13:48:33-04:00March 28, 2018|Uncategorized|

Primary Care Spending Declines Amid Health Care Cost Rise

At a time when health care costs continue to rise, spending for primary care is declining. This is the conclusion of an analysis of Health Care Cost Institute Data published on the Health Affairs Blog. According to the analysis, spending on primary health care declined six percent between 2012 and 2016 – more than twice the rate of the decline in spending for any other type of care. These results concern analysts because research shows that investment in primary care services generally improves population health at less cost. The decline is in utilization, not price, and while the reasons for [...]

iqtsupport2018-03-16T06:00:11-04:00March 16, 2018|Uncategorized|

Community Health Center Patients Often Have Housing Problems

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association. Among those problems: two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness. Some have homes that are not their own. Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions. Learn more about how housing challenges affect health and health care in the JAMA report “Prevalence of Housing [...]

iqtsupport2018-02-26T06:00:43-05:00February 26, 2018|Uncategorized|

Senators Push IRS on Non-Profit Compliance

Two prominent senators have written to the Internal Revenue Service seeking information about what the agency is doing to ensure that non-profit hospitals comply with the requirements for providing sufficient community benefits to justify their tax-exempt status. Senators Orrin Hatch (R-UT), chairman of the Senate Finance Committee, and Chuck Grassley (R-IA), a senior member of that committee, have asked the IRS to provide their committee with specific information about how the IRS evaluates non-profit hospitals’ Form 990 Schedule H; about guidance the IRS provides regarding how hospitals define their communities and their communities’ needs; about the performance and outcome of [...]

iqtsupport2018-02-16T09:38:58-05:00February 16, 2018|Uncategorized|

Physician-Owned Hospitals Returning?

In testimony before the House Ways and Means Committee, new Health and Human Services Secretary Alex Azar indicated that he may be receptive to easing restrictions on physician-owned hospitals. The Affordable Care Act made it difficult for doctors either to launch new hospitals of their own or to expand physician-owned hospitals already in operation, and many existing physician-owned facilities stopped serving Medicare patients. In response to a question from a committee member, Azar expressed his interest in working to enable physician-owned hospitals to operate. Learn more from this Fierce Healthcare article.

iqtsupport2018-02-15T09:56:12-05:00February 15, 2018|Uncategorized|