Policy Updates

Medicare Joint Replacement Program Produces Savings

The first reporting period for Medicare’s Comprehensive Care for Joint Replacement Model found that participating providers cut costs for episodes of care by more than $900, or 3.3 percent. Most of the savings, the Centers for Medicare & Medicaid Services reports, were achieved by sending patients to less-expensive post-acute-care settings or by reducing patients’ length of stay in such facilities. CMS also found that the program’s mandatory participants, located in 67 metropolitan statistical areas, achieved these savings without compromising quality of care as measured by post-discharge emergency room visits, hospital readmissions, and deaths. Learn more about CJR’s early results in [...]

iqtsupport2018-09-14T06:00:50-04:00September 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare|

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: a unified payment system for post-acute care long-term-care hospitals physician payments next steps in redesigning Medicare’s hospital quality and value programs While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the basis for new public policy. Go here to see the policy briefs and presentations offered to help guide MedPAC commissioners’ discussions about these and other issues.

iqtsupport2018-09-13T06:00:56-04:00September 13, 2018|Medicare, Medicare post-acute care, MedPAC|

Low-Acuity Use of Emergency Departments Declines

People are using hospital emergency departments less frequently for low-acuity medical problems, turning instead to retail clinics and urgent care. According to a new study of a limited patient population published in JAMA Internal Medicine, Visits to the ED for the treatment of low-acuity conditions decreased by 36% (from 89 visits per 1000 members in 2008 to 57 visits per 1000 members in 2015), whereas use of non-ED venues increased by 140% (from 54 visits per 1000 members in 2008 to 131 visits per 1000 members in 2015). There was an increase in visits to all non-ED venues: urgent care [...]

iqtsupport2018-09-12T06:00:33-04:00September 12, 2018|hospitals|

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.” In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action. For hospitals, they wrote that they seek further red-tape cutting in the areas of [...]

iqtsupport2018-09-11T06:00:49-04:00September 11, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations|

Congress Asks MedPAC to Look at Hospital Consolidation

The House Energy and Commerce Committee has asked the Medicare Payment Advisory Commission to examine the impact of hospital consolidation on patients and federal health care spending. In a letter signed by Energy and Commerce Committee chairman Greg Walden (R-OR), Health Subcommittee chairman Michael Burgess (R-TX), and Oversight and Investigations Subcommittee chairman Gregg Harper (R-MS), the Energy and Commerce Committee states that We request the Medicare Payment Advisory Commission (MedPAC) conduct research examining questions regarding the market trend of hospital consolidation and the degree to which such consolidation increases cost to the Medicare program and beneficiaries, including the costs for [...]

iqtsupport2018-09-07T06:00:18-04:00September 7, 2018|hospitals, Medicare, MedPAC|

Hospitals Find Bundled Payment Savings Through Attention to Nursing Care

Hospitals participating in Medicare’s Comprehensive Care for Joint Replacement model and its Bundled Payments for Care Improvement program are finding the savings the program seeks in part through greater attention to the post-acute-care needs of their patients. As a new study has found: One principal strategy was to reduce SNF referrals, using risk-stratification tools, patient education, home care supports, and linkages with home health agencies to facilitate discharges to home. Another was to enhance integration with SNFs: fifteen hospitals or health systems in our sample had formed networks of preferred SNFs to exert influence over SNF quality and costs. Learn [...]

iqtsupport2018-09-06T06:00:22-04:00September 6, 2018|Medicare|

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|

Next Generation ACO Nets Savings

Medicare’s Next Generation Accountable Care Organization model saved taxpayers $62 million in 2016, or 1.1 percent of the spending of the participating organizations, the Centers for Medicare & Medicaid Services has announced. The program also reduced hospitalizations 1.3 percent. In all, 18 organizations participated in the model program in 2016. Among them, four organizations accounted for more than half of the savings. In 2015, 45 organizations participated in the model and 51 are participating this year. Under the Next Generation ACO model, participants assume greater financial risk for their performance than under other Medicare models but also are eligible to [...]

iqtsupport2018-09-04T06:00:50-04:00September 4, 2018|Accountable Care Organization, ACO, Medicare|

CMS Reinforces Need for Budget Neutrality in Medicaid Waivers

States that seek federal waivers for permission to employ new approaches to serving their Medicaid population will have to pass more rigorous tests to ensure that those new approaches are budget-neutral, the Centers for Medicare & Medicaid Services has announced. In a detailed letter to state Medicaid directors, CMS outlines some of the current methodologies employed by states to demonstrate the budget neutrality of their waiver requests and details instances in which it will judge those methodologies differently in the future. A news release accompanying the letter explains that ….this letter marks the first time that CMS has formally outlined [...]

iqtsupport2018-08-31T06:00:11-04:00August 31, 2018|Medicaid|

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|