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Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017:  approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments.  Forty-eight [&hellip

Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices. So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program. The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient. Urban safety-net [&hellip

ACA Reduced Disparities in Access to Care

The Affordable Care Act has reduced socioeconomic disparities in access to health care in the U.S. According to a new study published in the journal Health Affairs, Health care access for people in lower socioeconomic strata improved in both states that did expand eligibility for Medicaid under the ACA and states that did not. However, gains were larger in expansion states. The absolute gap in insurance coverage between people in households with annual incomes below $25,000 and those in households with incomes above $75,000 fell from 31 percent to 17 percent (a relative reduction of 46 percent) in expansion states and from 36 percent [&hellip

CMS Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [&hellip

CMS Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [&hellip

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