Noteworthy News

Archive for July, 2012


Hospitals Worry About Lost DSH Money

Safety-net hospitals across the country are worried about what will happen come 2014, the New York Times reports, when the Affordable Care Act’s individual insurance mandate and Medicaid expansion take effect and they lose funds they currently receive from the federal government to help with the cost of caring for their low-income and uninsured patients. Hospitals that care for large numbers of such patients receive what are known as disproportionate share hospital payments, commonly referred to as “DSH,” from both Medicare and Medicaid.  Under the 2009 health care reform law, however, those payments will be reduced drastically in anticipation of [&hellip

Are Readmission Penalties Bad Medicine for Medicare Patients?

As the federal government prepares to penalize hospitals with high readmission rates, new research suggests that appropriate readmissions may actually result in better care for the nation’s seniors. According to new research, some hospitals that have high readmissions rates for the medical conditions that Medicare tracks – heart attacks, heart failure, and pneumonia – also have higher survival rates among patients with those conditions. Such findings, while preliminary, call into question the manner in which Medicare intends to adjust future payments to hospitals based on their readmission rates in the value-based purchasing program it will introduce in October of this [&hellip

Adequacy of Medicaid Payments Varies Widely Nation-wide

Medicaid payments for primary care services vary significantly in their adequacy in comparison to the payments providers receive from private insurers. According to a Washington Post blog based on a Forbes magazine report, state Medicaid payments for primary care range from 29 percent of private insurer payments (Rhode Island) to 112 percent of private insurer payments (Alaska). The figures also suggest that the states with the broadest Medicaid programs generally pay the least and those that cover more people pay better. Find the article, and an excellent 50-state map presenting payment comparability, in this Washington Post blog

Medicaid Cuts Looming in 13 States

Thirteen states either have cut Medicaid benefits, reduced provider payments, or tightened eligibility criteria or are in the process of doing so, according to a report from Kaiser Health News. Among the states making cuts are Illinois, Florida, California, Wisconsin, and Maryland. The cuts come less than two years before Medicaid eligibility is expected to increase significantly nation-wide as a result of the Affordable Care Act, although the extent of that expansion is now uncertain in light of the Supreme Court decision overturning the reform law’s requirement that states expand their Medicaid programs. Some states have already indicated that they [&hellip

Medicaid Directors Weigh in on Payment Reform

The National Association of Medicaid Directors has issued a policy paper on Medicaid payment and delivery system reform and innovation. In the policy brief, the association addresses fives types of reforms that states either are in the process of developing or are considering:  targeted payment adjustment policies, managed fee-for-service, bundled payments, managed care initiatives, and health homes. The paper also addresses the considerations states need to weigh before embarking on such reforms. Such reforms are of potentially great interest to urban safety-net hospitals because of the large numbers of Medicaid patients they serve – numbers that should grow greater in [&hellip

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