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A City Tackles Health Disparities

As the journal Health Affairs recently noted, “While 97 percent of health care costs are spent on medical care delivered in hospitals, only 10 percent of what determines life-expectancy takes place within the four walls of a health care facility. Where we live, work, and play each day drives our health and well-being.” In this context, the Health Affairs recently examined how Baltimore and its city Health Department are tackling a number of issues that affect the health of the city’s residents, including the city’s high infant mortality rate, violence, public health concerns, the opioid crisis, public safety and the [&hellip


The federal agency responsible for advising Congress on Medicaid and Children’s Health Insurance Program payment and access issues met last week in Washington, D.C. According to the Medicaid and CHIP Payment and Access Commission, The initial sessions of MACPAC’s September 2016 Commission meeting focused on hospital payment policy, first discussing MACPAC’s new work to develop an index of Medicaid inpatient payments across states and relative to Medicare, and later looking at how Affordable Care Act coverage expansions have affected hospitals serving a disproportionate share of low-income patients, including those with Medicaid coverage. The Commission then reviewed state policies for covering [&hellip

CMS Posts Tentative List of Essential Community Providers

The Centers for Medicare & Medicaid Services has posted on its web site a draft list of essential community providers for 2018. To qualify as essential community providers, organizations must serve predominantly low-income, medically underserved patients.  Qualified health plans must contract with at least 30 percent of the essential community providers in their markets and must offer contracts in good faith to at least one such provider in each of six categories, including federally qualified health centers, hospitals, and family planning providers. Providers that believe they have mistakenly been excluded from the list may petition for inclusion. Find the draft list [&hellip

Amid Rising Improper Medicaid Payments, CMS Offers Help

With improper Medicaid payments nearly twice as high as they were just a few years ago, the Centers for Medicare & Medicaid Services is reaching out to state Medicaid programs with suggestions for how to reduce those improper payments. The problem? According to CMS, States are facing greater challenges keeping pace with stricter enrollment requirements, tracking providers who have been excluded from other States’ or Federal health care programs, and generally adapting to changing regulations for qualifications of certain provider types. In a new e-alert, CMS identifies factors that contribute to improper payments – things like ineligible and excluded providers, provider [&hellip

There’s More to Quality Than Readmissions, Study Suggests

Hospitals with high readmissions rates may also have lower mortality rates for some conditions, according to a new study. The study, published in the Journal of Hospital Medicine, found that patients suffering from heart failure, stroke, and chronic obstructive pulmonary disease who are served in hospitals with higher readmission rates have a slightly better chance of survival than if they were treated in hospitals with lower readmission rates. Such findings call into question the value of focusing on readmissions as a measure of the quality of care hospitals provide – a focus exemplified by Medicare’s hospital readmissions reduction program. Find the [&hellip

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