Noteworthy News

Archive for December, 2016

 

New Study: Social Risk Factors Affect Provider Performance and Patient Outcomes

Medicare patients with social risk factors fare worse than others in programs that measure quality and the providers that serve them also perform worse than others on quality measures. This news comes from a new report presented to Congress by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning Evaluation. The report, mandated by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, focused on nine Medicare payment programs: the hospital readmissions reduction program the hospital value-based purchasing program the hospital acquired condition reduction program the Medicare Advantage (Part C) quality star rating [&hellip

Feds Launch Medicare-Medicaid ACO Model

The Center for Medicare and Medicaid Innovation has announced a new Medicare-Medicaid Accountable Care Organization Model that it says …is focused on improving quality of care and reducing costs for Medicare-Medicaid enrollees. The MMACO Model builds on the Medicare Shared Savings Program (Shared Savings Program), in which groups of providers take on accountability for the Medicare costs and quality of care for Medicare patients. Through the Model, CMS will partner with interested states to offer new and existing Shared Savings Program ACOs the opportunity to take on accountability for the Medicaid costs for their assigned Medicare-Medicaid enrollees. In this new [&hellip

Medicare Program Biased Against Selected Hospitals

Medicare’s hospital-acquired conditions program unfairly penalizes large, large urban, and teaching hospitals, according to a new study. According to “Complication Rates, Hospital Size, and Bias in the CMS Hospital-Acquired Condition Reduction Program,” published recently in the American Journal of Medical Quality, the hospital-acquired conditions program, which last year penalized nearly 800 hospitals, disproportionately penalizes large, large urban, and teaching hospitals because its threshold for identifying poor-performing hospitals is too broad, it relies on results that in many cases are not statistically different, and it fails to recognize when hospital performance improves. To correct these biases, the study’s authors recommend adding [&hellip

Uninsured Patients, Provider Taxes Hurt Adequacy of Medicaid Payments

While Medicaid payments now typically cover more than the cost of Medicaid services in many states, they do not cover the costs of caring for low-income patients after providers care for uninsured patients and pay Medicaid provider taxes, a new study has found. According to a Health Affairs report, After accounting for supplemental payments, we found that in 2011, disproportionate-share hospitals, on average, received gross Medicaid payments that totaled 108 percent of their costs for treating Medicaid patients but only 89 percent of their costs for Medicaid and uninsured patients combined. However, these payments were reduced by approximately 4–11 percent after we accounted for provider [&hellip

“Cures” Bill Gives NAUH Legislative Victory

The new 21st Century Cures Act includes something private urban safety-net hospitals have long advocated: socio-economic risk adjustment of Medicare’s hospital readmissions reduction program. NAUH has been urging Congress and the administration to introduce such a risk-adjustment component ever since the 2010 health care reform law was adopted. The bill, passed by Congress and signed earlier this week by President Obama, requires the Centers for Medicare & Medicaid Services to introduce a system of such adjustments to ensure that hospitals that serve especially large numbers of socio-economically challenging patients are not treated unfairly by the Medicare program. While the bill [&hellip

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