Noteworthy News

Archive for Medicare

 

Could Value-Based Pay Jeopardize Care for Low-Income Patients?

Physicians who serve large numbers of low-income patients are more likely to incur penalties under Medicare value-based purchasing programs. So concludes a new study in Annals of Internal Medicine. According to the report, Performance differences between practices serving higher- and those serving lower-risk patients were affected considerably by additional adjustments, suggesting a potential for Medicare’s pay-for-performance programs to exacerbate health care disparities.  This result is based on a study of the Medicare Value-Based Payment Modifier program, which no longer operates, but could have implications for other programs that seek to reward or penalize practitioners based on the outcomes they produce. [&hellip

The Battle Over 340B

Hospitals and other health care providers say it is an essential tool in ensuring access to care, and to prescription drugs, for their low-income patients. Pharmaceutical companies say it has expanded beyond its original purpose and is being used by hospitals to pad their profits. Members of Congress are divided:  some are supportive and some are skeptical. The section 340B program that requires drug companies to provide discounts to selected hospitals and other providers that serve large numbers of low-income patients has been the subject of controversy in recent years.  During that time, the administration has generally sided with hospitals [&hellip

Is Readmissions Reduction Program Hurting Some Patients?

A new study suggests that the decline in avoidable hospital readmissions of Medicare patients driven by the federal program’s hospital readmissions reduction program may be harming cardiac patients. According to a new study published in the journal JAMA Cardiology, while the readmissions reduction program has reduced readmissions among heart failure patients from 20 percent before the program was launched to 18.4 percent, the mortality rate among the same patients rose from 7.2 percent to 8.6 percent – 5400 more deaths a year. To learn more about the study, its results, why experts believe this  may be happening, and information about [&hellip

Administration Moving Away From Value Pay?

First, new Medicare programs for lump-sums payments for cardiac care and joint replacements were scaled back. Then, additional doctors were exempted from a new payment system that would have paid them more for the results they produce than for the quantity of care they provide. Next, the Department of Health and Human Services presented a document outlining a new direction for its Center for Medicare and Medicaid Innovation. And it announced that it was seeking input from doctors on payment policy. All suggest that if the Trump administration is not moving away for paying for quality rather than quantity it [&hellip

GAO Urges Medicare Action on Opioids

The Centers for Medicare & Medicaid Services is not doing enough to oversee the prescribing of opioids to Medicare beneficiaries. Or so concludes the U.S. Government Accountability Office. According to the GAO, CMS provides guidance to Medicare drug plans “…but does not analyze data specifically on opioids.”  Also, according to the GAO, …CMS does not identify providers who may be inappropriately prescribing large amounts of opioids separately from other drugs, and does not require plan sponsors to report actions they take when they identify such providers.  As a result, CMS is lacking information that it could use to assess how [&hellip

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