Policy Updates

Too Many Medicare APMs?

MedPAC thinks maybe that’s the case. At the recent meeting of the Medicare Payment Advisory Commission, the agency’s commissioners suggested that they may recommend that the Centers for Medicare & Medicaid Services reduce its assortment of alternative payment model programs. As reported by MedPage Today, a draft of MedPAC’s June report to Congress states that The [Health and Human Services] Secretary should implement a more coordinated portfolio of fewer alternative payment models (APMs) that support the strategic objectives of reducing spending and improving quality. In recent years CMS’s Center for Medicare and Medicaid Innovation has tested 54 different APMs; few [...]

iqtsupport2021-03-11T06:00:58-05:00March 11, 2021|Alternative payment models, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s March meeting were: Medicare beneficiary access to care in rural areas skilled nursing facility value-based purchasing program and proposed replacement streamlining CMS’s portfolio of alternative payment models balancing efficiency with equity in Medicare Advantage benchmark policy relationship between clinician services and other Medicare services revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs Medicare’s vaccine coverage and payment separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency [...]

iqtsupport2021-03-10T06:00:08-05:00March 10, 2021|Medicare, MedPAC|

Analysts Look at Medicare Wage System

The Congressional Research Service has published a new report on the Medicare hospital wage index system. The agency undertook its analysis because Some Members of Congress, hospitals, and independent analysts have expressed interest in the differences in Medicare hospital payments by geographic area, based on the wage index. Some of these stakeholders have recommended changes to the wage index to more accurately reflect labor market forces faced by hospitals. Although some modifications to the wage index have been implemented, there is no consensus about systematic reforms. In the report the CRS describes how the geographic wage system works and what [...]

iqtsupport2021-03-09T06:00:24-05:00March 9, 2021|Medicare, Medicare reimbursement policy|

Coronavirus Update for Monday, March 8

The following is the latest COVID-19 information from the federal government as of 2:45 p.m. on Monday, March 8. New CDC Guidance for Fully Vaccinated People The CDC has issued new guidance on how people who are fully vaccinated can interact safely with others, including those who have and those who have not been vaccinated. Learn more from the following resources: the CDC’s news release announcing the new guidance the new guidance itself the scientific rationale for the CDC’s guidance additional background information for fully vaccinated people on how to protect themselves and others White House The White House [...]

iqtsupport2021-03-09T06:00:21-05:00March 9, 2021|Coronavirus, COVID-19|

Coronavirus Update for Friday, March 5

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Friday, March 5. White House The White House has posted a transcript of the March 3 press briefing provided by its COVID-19 response team and public health officials. The White House has announced two new members of its COVID response team: Charles Anderson – director of economic policy and budget Sam Berger – director of strategic operations and policy Centers for Medicare & Medicaid Services CMS has established Medicare codes for billing for the Janssen Biotech COVID-19 vaccine (the Johnson & Johnson vaccine). [...]

iqtsupport2021-03-08T06:00:47-05:00March 8, 2021|Coronavirus, COVID-19|

MACPAC Looks at Recipients of Provider Relief Fund Grants

What kinds of providers did and did not receive grants from the CARES Act’s Provider Relief Fund? What were the obstacles to receiving those COVID-19 relief grants and why did some providers fare better in the distribution of Provider Relief Fund resources than others? These questions and more are addressed in “COVID Relief Funding for Medicaid Providers,” a new analysis released by the Medicaid and CHIP Payment and Access Commission.

iqtsupport2021-03-05T06:00:44-05:00March 5, 2021|MACPAC, Medicaid|

Bundled Payments Produce Savings Among Privately Insured

Bundled payments for a limited number of surgical procedures produced a savings of 10.7 percent among privately insured patients according to a study by the RAND Corporation. For the study, participants working for self-insured employers who received three types of surgery – total knee and hip replacement, spinal fusion, and bariatric weight-loss procedures – were offered the opportunity to have those procedures without cost-sharing in exchange for undergoing surgery by specific providers that agreed to accept a bundled payment for the procedure and 30 days of post-surgical care. The result was a savings of 10.7 percent in costs, 85 percent [...]

iqtsupport2021-03-04T06:00:43-05:00March 4, 2021|Uncategorized|

Coronavirus Update for Tuesday, March 2

The following is the latest COVID-19 information from the federal government as of 2:45 p.m. on Tuesday, March 2. White House The White House has posted a transcript of the March 1 press briefing provided by its COVID-19 response team and public health officials. Department of Health and Human Services HHS has announced a new round of appointments to positions in the department. The new appointees are: Office of the Secretary Rachel Pryor, Counselor for Health Policy Office of the Assistant Secretary for Public Affairs Florence Elizabeth “Beth” Lynk, Deputy Assistant Secretary for Public Affairs (Health Care) Office of [...]

iqtsupport2021-03-03T08:34:08-05:00March 3, 2021|Coronavirus, COVID-19|

Coronavirus Update for Friday, February 26

The following is the latest COVID-19 information from the federal government as of 2:30 on Friday, February 26. Congress The House Budget Committee has passed a COVID-19 relief bill. The following is a summary of the bill’s major spending, how it differs from the previous proposals submitted to the Budget Committee by other House committees, and what the bill does not do. Major Spending Categories The bill, which calls for $1.9 trillion in federal spending and tax credits, proposes: $350 billion for emergency aid to states, local, and tribal governments. $195 billion for state governments, with most of it [...]

iqtsupport2021-03-01T06:00:45-05:00March 1, 2021|Coronavirus, COVID-19|

Medicare Pays Far More Than Medicaid for Brand-Name Drugs

Medicare pays three times as much for brand-name drugs at retail pharmacies as Medicaid and two-and-a-half times more for specialty drugs, according to a new analysis by the Congressional Budget Office. The vast difference occurs because of how drug prices are established for the two programs. Under Medicare Part D, individual payers and manufacturers negotiate prices based on commercial market conditions while for Medicaid, federal law requires manufacturers to provide rebates. Learn more about the differences between Medicare and Medicaid prescription drug prices, how and why those differences occur, and their implications in the CBO report “A Comparison of Brand-Name [...]

iqtsupport2021-02-26T06:00:54-05:00February 26, 2021|Medicaid, Medicare|