Policy Updates

Medicaid Per Capita Caps Explained

In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to resurface in the near future. Among other things, the article explains what per capita caps are and how they would work describes how per capita caps differ from current Medicaid policy considers how the implementation of per capita caps might affect low-income people, providers, and insurers Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid [...]

iqtsupport2017-04-19T06:00:53-04:00April 19, 2017|Medicaid|

Programs, Not Penalties, Drive Readmission Reductions

Participating in federal value-based payment programs does more to reduce hospital readmissions than penalties levied on hospitals with too many readmissions. Or so reports a new study published by JAMA Internal Medicine. According to the study, hospitals that participated in one or more of three Medicare value-based payment programs – its meaningful use of electronic health records program, the bundled payment for care initiative, or an accountable care organization (ACO) program – enjoyed bigger decreases in their avoidable Medicare readmissions than hospitals that participated in no such programs but were only subject to financial penalties levied under the Medicare hospital [...]

iqtsupport2017-04-18T06:00:36-04:00April 18, 2017|Accountable Care Organization, health care reform, hospitals|

New MACPAC Study Evaluates Medicaid, Medicare Payments

Medicaid payments to hospitals are comparable to or even higher than Medicare payments. Or at least they are once supplemental Medicaid payments are included. So concludes a new study by the Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises the states, Congress, and the administration on Medicaid and CHIP payment and access issues. In what MACPAC bills as the “first-ever study to construct a state-level payment index to compare fee-for-service inpatient hospital payments across states and to benchmark Medicaid payments to other payers such as Medicare,” the study found that Across states, base Medicaid [...]

iqtsupport2017-04-17T06:00:40-04:00April 17, 2017|MACPAC, Medicaid, Medicare|

Medical Homes and High-Need Patients

With five percent of patients accounting for 50 percent of health care costs, such high-need patients are the subject of increasing attention as health care providers search for better ways to serve them at less cost. Such patients are especially challenging when they lack the financial resources and personal support systems needed to address their considerable medical needs. One of those ways is through the concept of the medical home: an approach to primary care, also often referred to as a patient-centered medical home, that is a team-based approach to delivering patient-specific, coordinated, accessible care that focuses on quality and [...]

iqtsupport2017-04-14T06:00:55-04:00April 14, 2017|Uncategorized|

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.

iqtsupport2017-04-13T06:00:37-04:00April 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 [...]

iqtsupport2017-04-12T11:49:58-04:00April 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 [...]

iqtsupport2017-04-06T06:00:32-04:00April 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.

iqtsupport2017-04-04T06:00:10-04:00April 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 [...]

iqtsupport2017-04-03T06:00:50-04:00April 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 [...]

iqtsupport2017-03-29T06:00:30-04:00March 29, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicare|