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CMS Urges Improvements in Care for Physically, Mentally Disabled

New guidance issued by the Centers for Medicaid Services outlines how states can make better use of home care in serving physically and mentally disabled Medicaid beneficiaries. Those steps include establishing open registries of home care workers; establishing qualifications for such workers; and paying wages that will help foster continuity of care for the clients of those home care workers. In making these recommendations, CMS seeks to make greater use of managed long-term services and supports and home- and community-based services when serving individuals who might otherwise need costly nursing home care. Learn more about CMS’s recommendations and why it [&hellip

A Closer Look at Socio-Economic Risk Factors

The National Association of Urban Hospitals often points to the socio-economic status of the patients its members serve as constituting one of the greatest challenges urban safety-net hospitals face. That challenge typically takes two major forms: how to serve such patients more effectively and how to encourage public officials to shape government (Medicare and Medicaid) reimbursement policies that reflect this distinct challenge and treat such caregivers fairly. Now, the National Academy of Medicine has taken a closer look at the social determinants that play such a major role in community health and in the health of the residents of the [&hellip

NAUH Comments on Proposed Medicare Inpatient Rule: Part 1 of 5

In April the Centers for Medicare & Medicaid Services published its proposed rule governing how it plans to pay hospitals for Medicare-covered inpatient services in FY 2017. The rulemaking process includes an invitation to stakeholders to submit comments on what CMS has proposed. NAUH submitted extensive comments in response to the proposed rule, addressing six aspects of what CMS proposed: Medicare disproportionate share (Medicare DSH) payments the Medicare hospital readmissions reduction program inpatient rates observation status/the two-midnight rule the outlier threshold reporting data for the Medicare area wage index This week the NAUH blog presents NAUH’s comments. Our schedule is [&hellip

HHS Issues Report on Changes in Care in Urban, Rural Areas

The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation has issued a new report titled Impact of the Affordable Care Act Coverage Expansion on Rural and Urban Populations. The report looks at changes in coverage rates and access to care and how these populations have used federal tax credits to obtain health insurance. Find the report here

Background Information on Payment Methodologies and Benefit Design

The Urban Institute has issued two new papers with background information on health care payment methodologies and the design of health care benefits packages. The first paper, Payment Methods: How They Work, describes nine payment methodologies: fee schedules primary care capitation per diem payments to hospitals for inpatient visits DRG-based payments to hospitals for inpatient visits global budgeting for hospitals bundled payments global capitation for organizations shared savings pay for performance The second paper, Benefit Designs: How They Work, explains seven different types of benefit designs: value-based design high-deductible health plans tiered networks narrow networks reference pricing centers of excellence benefit design [&hellip

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