Noteworthy News

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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

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

New Approach to Helping Patients With Complex Needs

Five foundations have joined forces to pursue new approaches to serving patients with complex medical needs. The Commonwealth Fund, the John A. Hartford Foundation, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, and The SCAN Foundation engaged the Institute for Healthcare Improvement to identify promising ways of better serving patients with complex medical needs. Many such patients, the foundations believe, have adequate access to medical care yet struggle to find the coordination needed between medical, behavioral, and social services to stay well and avoid costly hospitalizations. The group’s first public product is The Playbook, which it describes as [&hellip

Retail Clinics Don’t Reduce Demand for ER Services

The presence of retail medical clinics near hospitals does not reduce the demand for low-acuity services at those hospitals’ emergency room. Or so reports a new study published in the Annals of Emergency Medicine. Contrary to what was expected amid the proliferation of retail medical clinics – there were only a little more than 100 such clinics in 2006 but more than 2000 today – patients are not choosing those clinics instead of hospital ERs for low-acuity medical needs. An important qualifier is that only about 60 percent of such retail clinics accept Medicaid, but most clinics are located in places [&hellip

Hospital Bad Debt Up in Ohio

While uncompensated care is down, bad debt is up at Ohio hospitals. According to a new report from the Ohio Hospital Association, hospital bad debt rose in that state from $1.04 billion in FY 2013, when the state had not expanded its Medicaid program, to $1.23 billion in 2014, after Medicaid expansion had begun. Why? The increase was “…spurred by the growth in high deductible health plans,” the report states. At the same time, what the association calls “charity care” fell from $1.03 billion to $809 million. Increased bad debt as a result of the purchase of high-deductible health insurance [&hellip

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