Policy Updates

MedPAC: New Medicare Post-Acute Payment System Needed – Soon

Medicare should implement a unified, site-neutral payment system for post-acute care as soon as 2021, the Medicare Payment Advisory Commission has decided. Current efforts to develop and implement such a system should be accelerated, Congress’s advisors on Medicare payment issues decided. While MedPAC’s recommendations are not binding, they are highly respected by Congress and federal regulators and often find their way into new public policy. MedPAC will present its latest recommendations to Congress in June. For more information about MedPAC’s position on post-acute-care payments, see this article in McKnight’s Long-Term Care News.

2017-04-13T06:00:37-04:00April 13, 2017|Medicare, Medicare post-acute care, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Committee met last week in Washington, D.C. On the MedPAC agenda were the following issues: Part B drug payment policy issues using premium support in Medicare implementing a unified payment system for post-acute care an overview of the medical device industry regional variation in Medicare Part A, Part B, and Part D spending and service use measuring low-value care in Medicare payment and plan incentives in Part D the role of Medicare policy in provider consolidation Find the issue briefs and presentations that supported MedPAC commissioners’ discussion of these issues here and find a transcript of [...]

2017-04-12T11:49:58-04:00April 12, 2017|Medicare, MedPAC|

ACA Improved Hospital Financial Performance

Hospitals in states that expanded their Medicaid programs under the Affordable Care Act enjoyed improved financial performance, a new analysis has found. According to the report from the Urban Institute and the Robert Wood Johnson Foundation and based on FY 2015 data, In states that expanded Medicaid through the ACA, hospitals had $5.0 million in increased Medicaid revenue and $3.2 million decreased uncompensated care costs, on average per hospital. Hospitals in states that expanded Medicaid through the ACA improved average operating margins by 2.5 percentage points. Small hospitals, for-profit and non-federal government-operated hospitals, and those in non-metropolitan areas saw the [...]

2017-04-06T06:00:32-04:00April 6, 2017|Affordable Care Act, hospitals|

New County Health Rankings Published

The Robert Wood Johnson Foundation has published health rankings for every county in the country. Among the health or health-related factors for which the rankings provide data are: demographic information quality of life health factors percentage of population uninsured supply of health care providers and services socio-economic factors the physical environment Find the county health rankings here.

2017-04-04T06:00:10-04:00April 4, 2017|Uncategorized|

To Require Work or Not to Require Work

That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants. In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act.  Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement. Does the lack of a work requirement encourage people in Medicaid expansion states [...]

2017-04-03T06:00:50-04:00April 3, 2017|Medicaid|

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far?  CMS recently released three reports that evaluate different aspects of the program.  Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial [...]

Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well:  replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid.  Among [...]

2017-03-29T06:00:07-04:00March 29, 2017|Medicaid, Medicare|

Non-Profit Illinois Hospitals Keep Tax Exemption – for Now

Non-profit Illinois hospitals will not have to start paying local property taxes. At least not right away. That decision comes from the Illinois Supreme Court, which did not address the question of whether hospitals merit exemption from the local property taxes that some Illinois communities seek to impose on them.  Instead, the Supreme Court concluded that the lower courts that ruled unconstitutional the law giving these hospitals their tax-exempt status lacked the jurisdiction to making such a ruling. So the Illinois Supreme Court sent the case back to a circuit court to be reconsidered. Learn more about the latest in [...]

2017-03-26T06:00:40-04:00March 26, 2017|hospitals|

MACPAC Looks at Medicaid DSH

Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act. So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues. In its March 2017 report to Congress, MACPAC writes that In both expansion and non-expansion [...]

2017-03-23T06:00:53-04:00March 23, 2017|Affordable Care Act, hospitals, Medicaid|

MedPAC Offers Provider Rate Recommendations for FY 2018

The Medicare Payment Advisory Commission has submitted its annual Medicare payment rate recommendations to Congress. The recommendations, required by law, include: rate increases as required by current law for hospital inpatient payments, hospital outpatient payments, physicians, other health professional services, and outpatient dialysis payments; no updates for ambulatory surgical centers, skilled nursing facilities, long-term-care hospitals, and hospices; and five percent rate reductions for home health agencies and inpatient rehabilitation facilities. MedPAC continued its past practice of recommending reform of the manner in which Medicare pays for post-acute-care services, maintaining that the unified payment system it has proposed would save $30 [...]

2017-03-22T06:00:14-04:00March 22, 2017|Medicare, MedPAC|
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