Noteworthy News

Archive for November, 2013

 

MedPAC Hints at Shared Risk for Medicare ACOs

The independent agency that advises Congress on Medicare payment issues is interested in seeing Medicare accountable care organizations (ACOs) share the financial risk associated with serving their members. At a recent public meeting, members of the Medicare Payment Advisory Commission (MedPAC) noted that the first round of Medicare ACOs share in the savings they help generate while serving their members.  An appropriate next step, some MedPAC members maintained, would be for those ACOs to share the financial risks associated with failing to produce such savings. Currently, ACOs begin with a three-year cycle of no risk but a share of savings.  [&hellip

CMS Offers Guidance on Medicare “Two-Midnight Rule”

The Centers for Medicare & Medicaid Services (CMS) has published an FAQ to give providers guidance on the application of its so-called two-midnight rule governing when certain medical situations qualify for patient admission and when they should be classified as Medicare outpatient observation status.  See that FAQ here

Future Doc Shortage Overstated?

A new study suggests that the Affordable Care Act may not lead to the shortage of primary care physicians previously anticipated. According to a new study by the RAND Corporation, earlier projections were based on physician practices not altering the manner in which they serve their patients and also ignored Affordable Care Act provisions that envisioned a greater role in the delivery of primary care for nurse practitioners and physician assistants.  Specifically, these professionals are expected to be heavily involved in nurse-managed health centers and patient-centered medical homes. As a result, the need for more primary care physicians may be [&hellip

NAUH Member Part of New Approach to Serving High-Volume ER Patients

It is well known by now that a very small proportion of Medicaid patients account for a very high proportion of Medicaid spending, and hospitals and other providers are constantly searching for new and better ways to serve those who show up frequently in their emergency rooms. NAUH member Jersey City Medical Center is part of such an effort, and that effort is yielding major results:  better care for patients, lower Medicaid costs for the state, and an enhanced capacity to deliver high-quality outcomes for hospitals.  Along with other hospitals in New Jersey, the Jersey City Medical Center is using [&hellip

Congress Could Be Closing in on Medicare “Doc Fix”

The leaders of key congressional committees have agreed on a new approach to paying doctors for caring for Medicare patients that would eliminate the sustainable growth rate formula, prevent the scheduled January 1, 2014 cut of 25 percent in Medicare physician fees, and chart a new course away from paying physicians for Medicare services on a fee-for-service basis. A draft of the proposal was released last week by the chairmen of the Republican-controlled House Ways and Means Committee and the Democratic-controlled Senate Finance Committee, suggesting bipartisan support for the proposal, which quickly received guarded support from various health care interest [&hellip

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