Noteworthy News

Archive for October, 2014


To Increase or Not to Increase? That is the Question

To induce more primary care providers to serve Medicaid patients at a time when Medicaid enrollment was about to increase significantly nation-wide, the Affordable Care Act raised Medicaid primary care reimbursement to the same level as Medicare rates for 2013 and 2014, with the federal government to pick up the tab for 100 percent of the increase in state spending for these services. With that two-year increase coming to an end, states now must decide whether to continue the increase and pay for it themselves or let their Medicaid primary care rates return to their old levels. According to a [&hellip

More Medicaid Expansion Coming?

Now that Arkansas, Pennsylvania, and Iowa have gained federal approval of Medicaid expansion proposals that call for more use of private insurers than states that simply expanded their existing Medicaid programs, it looks as if other states may follow a similar path. New Hampshire and Indiana are already pursuing federal approval of customized approaches to Medicaid expansion.  Now, it appears that Tennessee, Utah, and Wyoming may follow suit after the November elections, when the political implications of Medicaid expansion will not be as great for Republican governors. Medicaid expansion is especially important for urban safety-net hospitals because they serve so [&hellip

Innovation Center Introduces “Transforming Clinical Practices” Initiative

The federal Center for Medicare and Medicaid Innovation has launched a new, $840 million program designed to help clinicians achieve large-scale health transformation. According to the agency’s news release, its “Transforming Clinical Practices” initiative …will fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes, and coordinated health care systems. These applicants could include group practices, health care systems, medical provider associations and others. This effort will help clinicians develop strategies to share, adapt and further improve the quality of [&hellip

Medicaid Directors Weigh in On Managed Care Regulation

The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs. In a paper entitled “Medicaid Managed Care Modernization:  Advancing Quality Improvement,” the National Association of Medicaid Directors urges the Centers for Medicare Services (CMS) to work with the states to develop quality reporting measures that are both useful and not overly burdensome. The association also asks CMS to leave decisions about accrediting requirements for state Medicaid managed care programs in state hands and not to establish a national quality rating system for Medicaid managed care plans. [&hellip

Congressman Reiterates Call for Improving Medicare Readmissions Program

Congressman James Renacci (R-OH) is again asking his House colleagues to support his proposal to adjust Medicare’s hospital readmissions reduction program. Noting that in its current form the program penalizes hospitals that care for larger numbers of poorer, sicker patients and that this “jeopardizes the viability of hospitals that service this vulnerable population,” the congressman urges his colleagues to support his bill, H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmissions Program Act.  This bill calls for adjusting the program’s approach “to account for certain disparities in patient population…” The National Association of Urban Hospitals (NAUH) supports this bill [&hellip

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