Noteworthy News

Archive for April, 2017

 

Medical Homes and High-Need Patients

With five percent of patients accounting for 50 percent of health care costs, such high-need patients are the subject of increasing attention as health care providers search for better ways to serve them at less cost.  Such patients are especially challenging when they lack the financial resources and personal support systems needed to address their considerable medical needs. One of those ways is through the concept of the medical home:  an approach to primary care, also often referred to as a patient-centered medical home, that is a team-based approach to delivering patient-specific, coordinated, accessible care that focuses on quality and [&hellip

MedPAC Meets

The Medicare Payment Advisory Committee met last week in Washington, D.C. Among the issues on MedPAC’s agenda were: using premium support in Medicare regional variation in Medicare Part A, Part B, and Part D spending and service use measuring low-value care in Medicare the role of Medicare policy in provider consolidation Find the issue briefs and presentations that supported MedPAC commissioners’ discussion of these issues here and find a transcript of the two days of meetings here

To Require Work or Not to Require Work

That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants. In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act.  Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement. Does the lack of a work requirement encourage people in Medicaid expansion states [&hellip

CMS Clarifies Medicaid DSH Rule

Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs.  This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit. According to CMS, This rule clarifies federal requirements regarding the treatment of third party payers in determining the hospital-specific Medicaid DSH payment limit, which is set by statute as a hospital’s “uncompensated costs” incurred in providing hospital services to Medicaid and uninsured patients. The final rule makes clearer our existing policy that uncompensated costs include only those costs for Medicaid eligible individuals that remain [&hellip

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