Noteworthy News

Archive for Medicare regulations

 

Cures Law Addresses Shortcomings in Readmissions Program

The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The Cures Act changes this by instructing HHS to set different penalty thresholds [&hellip

MedPAC Meets

Last week the independent agency that advises Congress on Medicare payment issues met for two days in Washington, D.C. Among the issues on the agenda of the Medicare Payment Advisory Commission were: payments for hospital inpatient and outpatient services, ambulatory surgery centers, dialysis facilities, and hospice care payments for post-acute-care providers a unified payment system for post-acute-care services Medicare Advantage Medicare Part B and Part D payments Medicare-covered primary care services implementation of the Medicare Access and CHIP Reauthorization Act of 2015 Go here for links to the issue briefs and presentations used at the MedPAC meeting and for a [&hellip

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

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

“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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