Policy Updates

New Study Finds Bundled Payments Reduces Costs, Improves Care

A new study has concluded that the bundled payments programs being tested by Medicare reduce health care costs while improving the quality of care. The study covered Medicare Bundled Payment for Care Improvement (BPCI) results for the past four years and includes the Medicare hip and knee replacement bundled care program. And contrary to another recent study, this report did not find any increase in the volume of procedures during the study period. To learn more about the study’s methodology and findings, go here to read “Debunking the Argument that the Bundled Payment for Care Improvement Program (BPCI) Contributed to [...]

iqtsupport2017-02-16T16:05:06-05:00February 16, 2017|Medicare|

Group Seeks Preservation, Reform of Federal Innovation Efforts

A coalition of 35 patient, physician, and hospital groups has written to new Secretary of Health and Human Services Tom Price and asked him to continue the federal government’s exploration of new ways to deliver and pay for Medicare services but to seek certain improvements in how those efforts are undertaken. The coalition Healthcare Leaders for Accountable Innovation in Medicare asked Secretary Price for a reformed Center for Medicare and Medicaid Innovation so that it operates with … appropriately-scaled, time-limited demonstration projects, greater transparency, improved data-sharing, and broader collaboration with the private sector. The coalition also called for CMMI to [...]

iqtsupport2017-02-16T13:00:11-05:00February 16, 2017|Center for Medicare and Medicaid Innovation, CMMI, Medicare|

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts. For a closer look at Medicaid value-based purchasing, [...]

iqtsupport2017-02-15T13:00:30-05:00February 15, 2017|Medicaid|

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such [...]

iqtsupport2017-02-15T06:00:53-05:00February 15, 2017|Accountable Care Organization, ACO, Medicare|

GAO Looks at MLTSS Rates, Oversight

Federal oversight of the manner in which states pay for Medicaid-covered managed long-term services and supports and of the data states use to set the rates for those services and supports is lacking, according to a new study by the U.S. Government Accountability Office. In a review of such practices in six states, GAO found that states are not adequately linking payments and penalties to performance toward achieving MLTSS goals for providing more care in the community and are using outdated data to set rates that federal regulations require to be “appropriate and adequate.” Learn more about what the GAO [...]

iqtsupport2017-02-14T06:00:38-05:00February 14, 2017|Medicaid|

Cures Law Addresses Shortcomings in Readmissions Program

The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The Cures Act changes this by instructing HHS to set different [...]

iqtsupport2017-02-13T06:00:15-05:00February 13, 2017|Medicare regulations|

Budget Reconciliation Explained

Congress may use the federal budget reconciliation process to repeal some aspects of the Affordable Care Act. But what is the budget reconciliation process and how does it work? Kaiser Health News has created a brief video, with an accompanying transcript, that explains. Find that video here.

iqtsupport2017-02-10T09:07:01-05:00February 10, 2017|Affordable Care Act|

A New Approach to Treating the Underserved

Last month Congress passed the Expanding Capacity for Health Outcomes Act. The new law calls for the U.S. Department of Health and Human services to study a New Mexico project that employs distance learning to enhance the ability of the medical community to serve medically underserved areas. Launched by the University of New Mexico in 2003, Project ECHO takes advantage of telehealth techniques to employ medical specialists who consult via videoconference with primary care providers. This approach can be employed to help patients in rural and underserved rural areas and to assist those with limited mobility who have difficulty traveling [...]

iqtsupport2017-02-07T06:00:34-05:00February 7, 2017|Uncategorized|

Long-Awaited 340B Guidance Withdrawn

The long-awaited “guidance” that was expected to bring potentially major changes to the federal section 340B prescription drug discount program has been withdrawn by the Department of Health and Human Services’ Health Resources and Services Administration. The final guidance, based on proposed guidance released in mid-2015, was expected to redefine the patients, providers, and prescription drugs eligible to participate in the 340B program. The document was thought to be in the final stages of review by the Office of Management and Budget. Learn more about the proposed guidance, what it was expected to address, who is relieved and who is [...]

iqtsupport2017-02-06T06:00:56-05:00February 6, 2017|Uncategorized|

MACPAC Concerned About Prospect of Medicaid Block Grants

Members of the non-partisan legislative agency that advises Congress on Medicaid and CHIP issues expressed concern at their most recent meeting about the possibility of the federal government turning Medicaid into a block grant program. At their meeting in Washington, D.C. last week, members of the Medicaid and CHIP Payment and Access Commission discussed the steps they would need to take to advise policy-makers about the issues they would need to address in making such a major policy change and the possibility that such a shift would result in a reduction of funding for Medicaid over time. Learn more about [...]

iqtsupport2017-02-02T06:00:53-05:00February 2, 2017|Medicaid|