Policy Updates

Participation in Alternative Payment Models Rises

In 2017 nearly 360,000 clinicians will participate in Medicare and Medicaid Alternative Payment Model programs sponsored by the Centers for Medicare & Medicaid Services. CMS also reports that this year 570 accountable care organizations, including 131 that bear risk, will serve more than 12.3 million Medicare and Medicaid beneficiaries. In addition, nearly 3000 primary care practices will participate in advanced primary care medical home models Find more about the growth of participation in CMS’s alternative payment models, including descriptions of the different models and breakdowns in the numbers of participants, in this CMS news release.

2017-01-27T06:00:22-05:00January 27, 2017|Accountable Care Organization, ACO, Centers for Medicare & Medicaid Services, Medicaid, Medicare|
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Medicaid Block Grants 101

Amid a great deal of speculation about the possibility of Congress and the new Trump administration turning Medicaid into a block grant program, Kaiser Health News has taken a step back to ask the question “What does this even mean?” Among the issues the new article addresses are: how a Medicaid block program might work how block grants differ from per capita caps why block grants are so interesting and so appealing to some public officials the chances of Medicaid becoming a block grant program See the Kaiser Health News article about Medicaid block grants here.

2017-01-26T13:00:32-05:00January 26, 2017|Medicaid|
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ACA Replacement?

While both the Trump administration and Congress insist that they will repeal and replace the Affordable Care Act, neither has yet provided information about what that replacement might look like. But one place worth looking for a possible glimpse into the future is the Affordable Care Act replacement plan proposed by Rep. Tom Price (R-GA), President Trump’s nominee to serve as Secretary of the Department of Health and Human Services. In 2015, Rep. Price proposed the Empowering Patients First Act as a vehicle for replacing the Affordable Care Act. While the bill was not adopted by Congress at the time, [...]

2017-01-25T06:00:05-05:00January 25, 2017|Affordable Care Act|
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HHS Transition Briefing Book Available

Prior to last November’s election, leadership at the U.S. Department of Health and Human Services prepared briefing materials for the transition staff of the winning candidate. That briefing book, HHS Presidential Transition Agency Landing Team Book, provides background material that HHS leadership believed would be useful for the incoming president’s transition team. That 118-page book is now publicly available; find it here.

2017-01-24T13:00:34-05:00January 24, 2017|Centers for Medicare & Medicaid Services|
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VBP No Boon for Patients

Medicare efforts to use value-based purchasing to foster improvement in the quality of hospital care has not improved the quality of patients’ experience in those hospitals, according to a new study. Addressing the quality of patients’ experience in the hospital, the Health Affairs study “Patient Hospital Experience Improved Modestly, But No Evidence Medicare Incentives Promoted Meaningful Gains” concluded about Medicare’s value-based purchasing efforts that While certain subsets of hospitals improved more than others, we found no evidence that the program has had a beneficial effect. See the study here.

2017-01-24T06:00:29-05:00January 24, 2017|Medicare|
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Health Centers Rise to Medicaid Challenge

The nation’s federally funded health centers responded to the Affordable Care Act by serving more Medicaid patients than ever and improving the quality of care they provide. According to a new study published in the journal Health Affairs, Medicaid expansion was associated with improved quality on four of eight measures examined: asthma treatment, Pap testing, body mass index assessment, and hypertension control. Learn more about how Medicaid expansion affected federally funded health centers and how those centers responded to that expansion in the study “At Federally Funded Health Centers, Medicaid Expansion Was Associated With Improved Quality Of Care,” which can [...]

2017-01-23T06:00:39-05:00January 23, 2017|Affordable Care Act, Medicaid|
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MedPAC: No Rate Increases for Nursing Homes

As it has since 2008, the Medicare Payment Advisory Commission has voted to recommend no pay increase or even market basket increase for Medicare payments to skilled nursing facilities. According to MedPAC, Medicare payments for nursing home care remain too high. MedPAC also voted to recommend no market basket increases for long-term-care hospitals and hospices and for a pay reduction for inpatient rehabilitation facilities. MedPAC will formally submit its recommendations to Congress in March. To learn more about MedPAC’s thoughts on Medicare reimbursement for post-acute-care services, see this article in McKnight’s Long-Term Care News.

2017-01-20T13:00:41-05:00January 20, 2017|MedPAC|
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MedPAC: Small Pay Raise for Hospital Inpatient, Outpatient Services

The independent agency that advises Congress on Medicare payment matters has recommended modest increases in Medicare payments for hospital inpatient and outpatient services in FY 2018. The Medicare Payment Advisory Commission voted in support of a market basket increase of approximately 1.85 percent for Medicare outpatient and inpatient services in FY 2018. MedPAC also voted to recommend a 0.5 percent increase in payments to physicians but no increase for ambulatory surgery centers. MedPAC will formally submit its recommendations to Congress in March. Learn more about these and other MedPAC recommendations for changes in Medicare provider reimbursement in this article on [...]

2017-01-20T06:00:18-05:00January 20, 2017|Medicare, MedPAC|
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