Noteworthy News

Archive for October, 2014


Increased Utilization by New Medicaid Patients Levels Off, Study Finds

Spikes in hospital emergency room and inpatient admissions attributed to patients who have recently obtained Medicaid coverage eventually taper off, according to a new study. According to the study Increased Service Use Following Medicaid Expansion is Mostly Temporary:  Evidence From California’s Low Income Health Program, dramatic increases in ER use and hospitalizations among those newly insured by Medicaid eventually level off and should not especially tax either hospital capacity or state Medicaid budgets. The study, performed by the UCLA Center for Health Policy Research, found that after pent-up demand for care among those who previously had limited access to services [&hellip

Teaching Hospitals Pitch More Residencies

With the country facing a physician shortage and the number of medical residencies capped by the 1997 Balanced Budget Act (because Medicare and Medicaid provide the primary funding for the residencies), teaching hospitals need an additional 4000 residency slots a year. This was the message conveyed recently to a gathering of congressional aides co-sponsored by the Association of American Medical Colleges. This issue is of great interest to the nation’s urban safety-net hospitals, many of which are teaching hospitals. Such an increase would cost $10 billion over the next ten years. Learn more about the case for more residency slots [&hellip

Medicare “Doc Fix” Problem – Again

Like a case of malaria, the Medicare doc fix problem just won’t go away. On 17 occasions since Congress established the formula for Medicare payments to physicians, Congress has intervened in the application of that formula to prevent steep reductions in those payments that threatened access to care for the nation’s seniors. The most recent patch expires next March, so discussions have begun on when, and how, Congress might intervene again – or if it might even pursue a permanent solution to what has become a seemingly permanent problem. Some observers believe Congress may seek to address the Medicare physician [&hellip

Medicare Announces Readmissions Penalties

Medicare will impose financial penalties in FY 2015 on the majority of U.S. hospitals for excessive patient readmissions. In all, 2610 hospitals face penalties that range from one one-hundredth of one percent to three percent of all Medicare payments.  Last year, the maximum penalty was two percent. The majority of hospitals in 29 states will be penalized and 39 hospitals face the maximum penalty of three percent.  Overall, the penalties will amount to $428 million.  Many hospitals will be penalized even though they reduced their readmissions in the past year. Medicare’s hospital readmissions reduction program was mandated by the Affordable [&hellip

Access to Care Lacking for New Medicaid Patients

The Office of the Inspector General of the U.S. Department of Health and Human Services (OIG) has found that even as Medicaid enrollment surges as a result of Affordable Care Act reforms, many of the newly insured are having trouble gaining access to care. The problem, outlined in a new report, is that states are not doing enough to ensure that the managed care organizations serving most new Medicaid patients have adequate provider networks.  As a result, some patients are waiting months for doctors’ appointments or must travel long distances for care. The review, undertaken at the request of Congress, [&hellip

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