Policy Updates

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|

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|