Policy Updates

The More High-Need Patients, the Better the Care

Physician practices that serve higher proportions of high-need patients have lower health care costs, fewer hospital admissions, and fewer emergency room visits than physician practices that serve lower proportions of high-need patients. This was the conclusion of researchers who analyzed four years of claims data for high-needs patients in Michigan. The study also found some evidence that smaller medical practices are more effective in serving high-need patients than larger practices. The study, “Outcomes For High-Needs Patients: Practices With A Higher Proportion Of These Patients Have An Edge,” was supported by the Commonwealth Fund, and is summarized by the fund here. [...]

iqtsupport2017-03-20T06:00:30-04:00March 20, 2017|Uncategorized|

Telehealth May Not Reduce Health Care Costs

Telehealth may increase rather than decrease health care costs, a new study has found. The study, performed by the Rand Corporation and based on a limited sampling of data from California, found that only 12 percent of telehealth doctor visits replaced office visits while the remaining 88 percent of telehealth encounters constituted new demand. The study focused on virtual visits for respiratory illnesses and found that the telehealth encounters often led to office visits and medical tests that increased annual spending on respiratory illnesses approximately $45 for each user. Learn more about the study, its methodology and findings, and reaction [...]

iqtsupport2017-03-16T06:00:12-04:00March 16, 2017|Uncategorized|

But is the Innovation Working?

Driven by government payers, private payers, and business demands, health care providers are engaging in delivery system innovation to an unprecedented degree. But is that innovation achieving its objectives? How can providers tell? A new post on the Health Affairs Blog offers guidelines for evaluating the effectiveness of delivery system innovation. Among other steps, it proposes identifying the target population the innovation seeks to serve; describing baseline performance; and documenting the components of the innovation. It also suggests how payers can be enlisted to help with this effort. Go here for the article “Strategies For Assessing Delivery System Innovations.”

iqtsupport2017-03-14T06:00:56-04:00March 14, 2017|Uncategorized|

Key Ingredients for Health Care Innovation

What conditions and considerations are needed for innovation in health care? A new article on the Health Affairs Blog asks this very question. To see the answers, go here to see the article “Innovative Environments In Health Care: Where And How New Approaches To Care Are Succeeding.”

iqtsupport2017-03-13T06:00:24-04:00March 13, 2017|Uncategorized|

MACPAC Looks at High-Cost Hepatitis C Drugs

The emergence of exceptionally high-cost drugs that offer unprecedented benefits for Hepatitis C patients has posed a considerable challenge to state Medicaid programs: the drugs offer cures, not treatment, yet their costs are potentially budget-busting. The Medicaid and CHIP Payment and Access Commission commissioned a study to evaluate how these new drugs and their cost have affected state Medicaid programs and the managed care organizations that serve most Medicaid beneficiaries. Among the issues the study considered were: state coverage and prior authorization policies the impact of the new drugs on state Medicaid budgets and Medicaid managed care organizations how these [...]

iqtsupport2017-03-10T06:00:07-05:00March 10, 2017|Medicaid|

MedPAC Discusses Post-Acute Payment Issues

At their public meeting last week, members of the Medicare Payment Advisory Commission discussed two important issues involving how Medicare pays for post-acute-care services. First, MedPAC members suggested that implementation of a new, unified, site-neutral payment system for post-acute care, mandated by the 2014 Improving Medicare Post-Acute Care Transformation Act (IMPACT), could be completed well before the legislation’s target date of 2024. Commissioners discussed the possibility of Medicare introducing such a new system, perhaps by phasing it in over a period of years, beginning in 2021. MedPAC commissioners also discussed recommending to Congress that it reduce Medicare payments for post-acute-care [...]

iqtsupport2017-03-09T06:00:15-05:00March 9, 2017|Medicare, MedPAC|

MACPAC Meets, Discusses Medicaid, CHIP Issues

The non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on a variety of Medicaid and State Children’s Health Insurance Program issues met last week in Washington, D.C. Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were: the flexibility of states in structuring and administering their Medicaid and CHIP programs state Medicaid responses to fiscal pressures studies requested by Congress on mandatory/optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis [...]

iqtsupport2017-03-08T11:26:27-05:00March 8, 2017|Medicaid|

MedPAC Meets, Discusses Issues

Members of the Medicare Payment Advisory Commission met for two days last week in Washington, D.C. to discuss a number of policy issues important to health care providers. Among those issues were: a unified payment system for post-acute care hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing homes refining merit-based incentive payment systems (MIPS) and Advanced Alternative Payment Systems (A-APMs) to encourage primary care Go here to see the issue briefs and presentations used to guide MedPAC commissioners’ deliberations.

iqtsupport2017-03-06T09:50:19-05:00March 6, 2017|Medicare, MedPAC|

Comparing “Repeal and Replace” Proposals

How can you keep score while Congress considers multiple proposals to repeal and replace the Affordable Care Act? The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals: you pick the proposals you want to compare and you select the aspects of those proposals that interest you. Find this new interactive tool here, on the web site of the Kaiser Family Foundation.

iqtsupport2017-02-21T06:00:08-05:00February 21, 2017|Affordable Care Act|

Changing Medicaid

With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider. Among them are: giving states greater flexibility in the design and implementation of their own Medicaid programs requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments limiting benefits employing incentives to encourage healthy behaviors The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years. Learn more about some of the options Congress will [...]

iqtsupport2017-02-17T06:00:54-05:00February 17, 2017|Medicaid|