Noteworthy News

Archive for Medicare


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

Hospitals Improving on Medicare Value-Based Measures

U.S. hospitals continue to improve their performance under Medicare’s value-based purchasing program. In FY 2018, 57 percent of hospitals will receive Medicare bonuses from the program, up from 55 percent in FY 2017.  Bonuses are generally small but for some hospitals will be more than three percent.  Roughly half of all hospitals will experience changes in their Medicare base rates.  The worst performers will see their payments decline 1.65 percent. In FY 2018, hospitals that succeed in the program will share $1.9 billion in bonus payments.  Funding for those payments in this budget-neutral program comes from CMS withholding two percent [&hellip

A Different Perspective on Telehealth

Residents of urban areas often have the same access-to-care problems as rural residents, although the latter receive far more attention. So concludes a new report published on the Health Affairs Blog. According to the analysis, urban and rural residents have similar access problems – and among urban residents, the problems in some instances are even greater.  One distinction: …while rural America has access problems because there are not enough doctors, urban America has access problems because there are not enough appointments. One potential solution to this problem, the report suggests, is focusing on access instead of geography and making telehealth [&hellip

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C. Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were: the merit-based incentive payment system telehealth a redesign of Medicare’s hospital value incentive program Many of the issues MedPAC addresses – including those noted above – are very important to urban safety-net hospitals. Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site

340B Changes Would Hurt Hospital Margins

Proposed changes in the federal section 340B prescription drug discount program would hurt hospital margins. So says Moody’s Investors Service, the credit rating agency. According to Moody’s, the margins of non-profit hospitals are already under pressure because revenue increases are not keeping pace with prescription drug costs.  Reductions of payments under the 340B program recently proposed by the Centers for Medicare & Medicaid Services would make a challenging situation worse, Moody’s speculates. Under the 340B program, eligible hospitals purchase prescription drugs at a discount, supply them to eligible outpatients, and use the savings they gain to provide additional services and [&hellip

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