Noteworthy News

Archive for July, 2013

 

Tackling Medicaid “Super-Users”

All urban safety-net hospitals have them:  a relatively small number of Medicaid patients who are constantly in need of care. Five percent of all Medicaid beneficiaries account for more than half of all Medicaid expenditures.  The challenges such patients pose are legitimate:  many have multiple chronic conditions. How best to serve these patients?  The Center for Medicaid and CHIP Services has been looking into this problem and the Center for Medicare and Medicaid Innovation and the Robert Wood Johnson Foundation have been underwriting demonstration programs designed to find better ways to care for these patients. Read more about the problem [&hellip

Docs Dropping Medicare in Growing Numbers

More than 9500 doctors stopped accepting Medicare in 2012 – nearly three times as many who dropped out of the program just three years earlier. In addition, the proportion of family doctors who accepted new Medicare patients that year fell from 83 percent in 2010 to 81 percent. While most doctors who leave Medicare cite what they consider to be its inadequate payment rates, some do not want to adopt electronic health records and others feel that they can fare better financially without the additional staff needed to process Medicare claims. While some Medicare patients choose to pay out of [&hellip

IOM Rejects Basing Medicare Payments on Geography

Differences in Medicare spending in different parts of the country are mostly the result of differences in the use of post-acute care services and not mere geography, the Institute of Medicine has concluded. The findings refute the assertion by members of Congress representing rural states that the hospitals they represent are underpaid by Medicare, and the IOM study was undertaken at Congress’s direction for that reason. In the new report Variation in Health Care Spending:  Target Decision Making, Not Geography, the IOM wrote that the majority of health care decisions are made at the provider or health care organization level, [&hellip

The Implications of Rejecting Medicaid Expansion

Twenty-one states have decided not to expand their Medicaid programs under the Affordable Care Act and another six states remain undecided. How will these decisions affect these states and their residents?  How many people who might have become eligible for Medicaid will remain uninsured?  How much federal Medicaid revenue will these states forgo?  How will these decisions affect hospitals’ uncompensated care costs?  How might payments to hospitals be affected? The National Association of Urban Hospitals (NAUH) supports Medicaid expansion in all states. A new study from the Urban Institute attempts to quantify the answers to these and other questions.  Find [&hellip

DSH Delay Bill Picks Up Co-Sponsors

A bill that would delay implementation of Medicaid disproportionate share (Medicaid DSH) and Medicare DSH payment cuts for two years now has 46 co-sponsors in the U.S. House of Representatives. H.R. 1920, the DSH Reduction Relief Act of 2103, would delay for two years the DSH cuts mandated by the Affordable Care Act. The rationale underlying the proposal is that between some states choosing not to expand their Medicaid programs as the reform law envisioned and the delay in imposing the mandate for businesses to help their employees with health insurance, the expected rise in the rate of insurance will [&hellip

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