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Don’t Slash Medicare Drug Payments, NAUH Asks CMS

The federal government should withdraw its proposal to drastically reduce Medicare payments for prescription drugs covered by the section 340B prescription drug discount program, NAUH has told the Centers for Medicare & Medicaid Services. CMS has proposed a 28 percent cut in those payments beginning in 2018. According to NAUH, the savings hospitals enjoy from 340B discounts enable them to expand the scope of the services they offer to their low-income patients and engage in additional community outreach.  This was the very reason Congress created the program, NAUH told CMS, and reducing 340B payments now would reduce those savings, undermine [&hellip

NAUH Urges CMS to Reconsider Proposed Outpatient Payment Changes

The federal government should not cut in half payments to physicians who care for their Medicare patients in off-campus, provider-based outpatient facilities. It also should reconsider the circumstances under which hospitals can move their off-campus, provider-based hospital outpatient departments, or expand the services those departments offer, without losing their provider-based hospital outpatient department status. These were among the comments NAUH offered to the Centers for Medicare & Medicaid Services in response to CMS’s proposed Medicare physician payment fee schedule for 2018. See NAUH’s entire letter to CMS about the proposed outpatient physician fee regulation here

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation [&hellip

Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017:  approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments.  Forty-eight [&hellip

Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices. So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program. The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient. Urban safety-net [&hellip

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