Policy Updates

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|

Senate Committee Looks at 340B Program

The Senate Health, Education, Labor, and Pensions Committee (HELP) held a hearing last week on the 340B prescription drug discount program. The hearing was prompted by complaints from pharmaceutical companies about the discounts they are required to provide to eligible providers and by concern that hospitals are insufficiently accountable for how they use the savings they derive from those discounts to serve their low-income patients. In addition, the Centers for Medicare & Medicaid Services recently reduced its Medicare payments to participating hospitals. During the hearing, Senate Republicans expressed support for the program but spoke of the need for greater transparency [...]

iqtsupport2018-03-22T06:00:56-04:00March 22, 2018|340b, hospitals|

MedPAC Issues 2018 Report to Congress

The Medicare Payment Advisory Commission has issued its 2018 report and recommendations to Congress. The report includes MedPAC’s recommendations for next year’s Medicare fee-for-service payments; a review of the Medicare Advantage and Medicare Part D programs, with recommendations; and a report telehealth required by the 21st Century Cures Act. For Medicare fee-for-service rates, MedPAC proposes: the inpatient and outpatient rate increases, physician and other health professional rate increases, and outpatient dialysis increase included under current law no increase for ambulatory surgical centers, long-term-care hospitals, and hospice providers no rate increase for skilled nursing facilities a five percent reduction of payments [...]

iqtsupport2018-03-21T06:00:04-04:00March 21, 2018|Medicare, MedPAC|

MACPAC Issues Annual Report, Recommendations to Congress

The Medicaid and CHIP Payment and Access Commission has published its annual report and recommendations to Congress. MACPAC’s report addresses three primary areas: Medicaid managed care, telehealth, and Medicaid disproportionate share payments (Medicaid DSH). With 80 percent of Medicaid beneficiaries now enrolled in managed care plans, MACPAC offers three major recommendations for improving Medicaid managed care efforts: permit states to require all of their Medicaid beneficiaries to enroll in a managed care plan extend Medicaid managed care section 1915(b) waivers from two to five years permit states to obtain waivers to waive freedom of choice and selective contracting restrictions MACPAC [...]

iqtsupport2018-03-20T06:00:31-04:00March 20, 2018|Medicaid, Medicaid managed care|

CMS Reports on Quality Measures Performance

The Centers for Medicare & Medicaid Services has published a new report detailing the progress of health care providers in meeting Medicare quality standards and improving their performance under those standards. The report, required every three years, focuses on 17 key indicators of quality in the delivery of health care as defined by 247 individual quality measures. The analysis found that: 670,000 patients improved their control of their blood pressure 510,000 fewer patients have poor control of their diabetes 12,000 fewer people died following hospitalization for a heart attack there were 70,000 fewer unplanned hospital readmissions nursing home residents suffered [...]

iqtsupport2018-03-19T06:00:39-04:00March 19, 2018|Medicare, Medicare regulations|

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|

New Report Details Key Health Care Provisions in February Budget Bill

The Congressional Research Service has published a new report describing the health care-related provisions in the Bipartisan Budget Act of 2018 that Congress passed last month to fund the federal government. A major part of that law was the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, and the new report includes descriptions of the Medicare, Medicaid, CHIP, public health, and other health care aspects of the law. Go here to find the Congressional Research Service report Bipartisan Budget Act of 2018 (P.L. 115-123): Brief Summary of Division E—The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act.

iqtsupport2018-03-14T06:00:47-04:00March 14, 2018|Medicaid, Medicare|

Study Looks at Medicaid and Managed Care

A new Commonwealth Fund study examines how managed care plans have tackled serving new members in Affordable Care Act-authorized Medicaid expansion states. According to the report, these managed care organizations have …focused on identifying and helping high-risk populations and addressing the social determinants of health. MCOs are testing value-based payment strategies that link payment with performance and are increasingly focused on engaging patients in their care. Leaders report common challenges: setting appropriate payment rates; managing members whose needs differ from traditional Medicaid beneficiaries; ensuring access to specialty care; and effectively implementing payment reform and practice transformation. Learn more about how [...]

iqtsupport2018-03-13T06:00:58-04:00March 13, 2018|Affordable Care Act, Medicaid, Medicaid managed care|

Non-Profit Rating Downgrades Exceeded Upgrades in 2017

Moody’s downgraded more non-profit hospital credit ratings than it raised in 2017. The credit-rating company attributed the downgrades to nursing shortages in some markets and rising pharmaceutical and supplies costs. Nearly a third of the downgrades were in just two states: Ohio and Pennsylvania. Learn more about Moody’s 2017 downgrades and upgrades in this report from Becker’s Hospital Review.

iqtsupport2018-03-12T09:49:18-04:00March 12, 2018|hospitals|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. last week to discuss a number of Medicaid and CHIP meetings. The following is MACPAC’s summary of this meeting. MACPAC’S March 2018 meeting began with a review of two draft chapters with recommendations that will be included in MACPAC’s June 2018 report, the first to improve operation of the Medicaid drug rebate program and the second to improve the clarity of substance use disorder (SUD) confidentiality regulations. At the opening session the Commission reviewed a draft chapter on Medicaid drug policy and later voted to approve [...]

iqtsupport2018-03-08T06:00:35-05:00March 8, 2018|MACPAC, Medicaid, Medicaid long-term services and supports, Medicaid regulations for the disabled|