Policy Updates

800 Hospitals Face Medicare Penalties

800 hospitals will see their Medicare payments reduced one percent this year because they are among the 25 percent of hospitals in the U.S. with the highest rate of hospital-acquired conditions. Among the 800 hospitals are 110 that are being penalized for the fifth year in a row. Medicare’s hospital-acquired condition reduction program tracks a variety of medical problems, including infections, blood clots, sepsis, hip fractures, bedsores, and others. Every year, the 25 percent of eligible providers – the program excludes significant numbers of hospitals – are penalized even if their performance for hospital-acquired conditions is superior to the previous [...]

iqtsupport2019-03-05T06:00:59-05:00March 5, 2019|hospitals, Medicare, Medicare regulations|

Hospitals Show Mixed Results on Investments

Some hospitals are doing much better than others with their investments. According to a new report, several large health systems have recently reported major losses with their investments. On the other hand, a report late last year found that roughly half of hospitals’ net margins over the past two years has come from investment income. Learn more from the Becker’s Hospital Review article “Investment income made up almost 50% of hospitals' net margin in past 2 years.”

iqtsupport2019-03-04T06:00:01-05:00March 4, 2019|hospitals|

Grassley, Senate Finance to Resume Probe of Non-Profit Hospitals

The Senate Finance Committee will launch a review of non-profit hospitals and whether they are meeting the formal community benefit standards required to justify their tax-free status. This subject has long been of interest to committee chairman Chuck Grassley, who has returned as committee chair. He pursued the same question of the hospitals’ non-profit status and community benefit provide while leading the Senate Finance Committee from 2003 to 2007 and also as a member of the committee, although not its chair, in recent years. In a letter to the commissioner of the Internal Revenue Service, which is responsible for reviewing [...]

iqtsupport2019-03-01T06:00:44-05:00March 1, 2019|hospitals|

Nursing Home Study: More Medicaid Patients=Worse Care

Nursing homes that serve larger proportions of Medicaid patients have lower quality ratings, according to a new study from the American Health Care Association, a long-term-care provider trade group. The study also found that: For-profit nursing homes care for more Medicaid patients than non-profits. Rural nursing homes care for more Medicaid patients than urban facilities. Large facilities care for a higher proportion of Medicaid patients than smaller facilities. Learn more about the study and the theories behind some of these findings in the McKnight’s Long-Term Care News article “AHCA study: Facilities with higher Medicaid populations have poorer quality outcomes.” [...]

iqtsupport2019-02-28T13:00:01-05:00February 28, 2019|Medicaid, post-acute care|

OIG: Medicare Errs in Paying for Some Skilled Nursing Care

Medicare is erroneously paying for skilled nursing facility care for beneficiaries who did not spend three nights in an acute-care hospital, the U.S. Department of Health and Human Services’ Office of the Inspector General has concluded. Based on a limited sampling, the OIG estimates that Medicare spent $84 million on such ineligible services from 2013 through 2015. A new report from the OIG explains that We attribute the improper payments to the absence of a coordinated notification mechanism among the hospitals, beneficiaries, and SNFs to ensure compliance with the 3-day rule. We noted that hospitals did not always provide correct [...]

iqtsupport2019-02-28T06:00:33-05:00February 28, 2019|Medicare reimbursement policy|

Nursing Home Occupancy Down

Nursing home occupancy fell from 83.07 percent in 2013 to 80.24 percent at the end of 2017, according to a new report. The amount of time patients spend in nursing homes is falling as well. Declining occupancy and length of stay and shrinking reimbursement have led to nursing home closings and a six percent decline in cash on hand between 2013 to 2017. Learn more about some of the challenges facing skilled nursing facilities in the McKnight’s Long-Term Care News report “Dwindling reimbursement, occupancy numbers chipping away at skilled nursing margins, new analysis finds.”

iqtsupport2019-02-27T13:00:08-05:00February 27, 2019|post-acute care|

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|

States Taking Different Paths to Pay for Medicaid Expansion

With the federal share of Medicaid expansion falling to 90 percent next year, states that expanded their Medicaid programs under the Affordable Care Act are now exploring new ways to raise the money to pay for the 10 percent for which they will soon by responsible. Some are implementing hospital or insurer taxes while others are increasing existing taxes on hospitals and health insurers. New Hampshire is directing part of the proceeds from a liquor tax for this purpose and other states have introduced cigarette taxes. Some are charging premiums to Medicaid beneficiaries and introducing Medicaid work requirements so they [...]

iqtsupport2019-02-25T06:00:37-05:00February 25, 2019|Affordable Care Act, Medicaid|

A New Community Benefit: Free Medical School

A health system has decided on a new approach to the community benefit spending that is required to enable it to retain its non-profit status: free medical school. Kaiser Permanente, the non-profit California-based health system that will launch a new medical school in 2020, has announced that it will waive tuition for students in its first five graduating classes and include the lost revenue associated with free tuition in its community benefit spending. Company officials also hope the freedom from the debt associated with medical school loans will encourage students to pursue careers in family medicine and lower-paying specialties. Learn [...]

iqtsupport2019-02-22T06:00:25-05:00February 22, 2019|hospitals|