Noteworthy News

 

Medicaid is Toughest Insurer for Providers

Medicaid is the hardest insurer for providers when it comes to billing. Or so reports a new study published in the journal Health Affairs. According to this analysis, Medicaid claims take longer to file, are more likely to be rejected, more likely to be challenged, and take longer to be paid than Medicare and private insurance claims.  While the biggest problem is Medicaid fee-for-service claims, even Medicaid managed care claims pose more problems than Medicare and private insurance claims. This can pose a special challenge to urban safety-net hospitals because they care for so many more Medicaid patients than the [&hellip

Eat! You’ll Feel Better

And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food:  some received general meal deliveries while others received food tailored to their individual medical conditions.  The purpose:  address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants in the medically tailored meal program also had fewer inpatient [&hellip

Safety-Net Hospitals Improve More on Readmissions But Still More Likely to be Penalized

Hospitals that serve large numbers of minority patients are reducing their Medicare readmissions rates more than other hospitals but are still more likely to be penalized under Medicare readmissions reduction program. This is one of the findings in a new study published in the journal Health Affairs. According to the study, hospitals that serve larger numbers of minority patients – typically, safety-net hospitals – are more likely to be penalized for readmissions than other hospitals because even though they are reducing their readmissions rates faster than other hospitals, their performance is compared, unfavorably, to hospitals that had fewer Medicare readmissions [&hellip

Tackling Social Determinants of Health

The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients. A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations:  Developing the business case,” seeks to serve as a manual for providers seeking to move into this relatively new territory. The report takes providers through [&hellip

340B Program Getting the Job Done

The oft-scrutinized section 340B prescription drug discount program is doing what the program is supposed to do, according to a new analysis published on the Health Affairs Blog. According to the report, 340B DSHs treat significantly more low-income patients than non-340B hospitals, provide a disproportionate amount of the nation’s uncompensated and unreimbursed care, and are more likely to provide specialized services that are critical to low-income patients but which are often underpaid. In addition, 340B …has saved billions in drug costs while providing free or discounted care to millions of patients who might otherwise be unable to get needed care. [&hellip

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