Noteworthy News

Archive for December, 2014


Access to Primary Care a Medicaid Problem, HHS OIG Says

Many of the primary care providers that participate in Medicaid managed care programs are inaccessible to those plans’ members, according to a new report by the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG). As states’ Medicaid rolls grow and they direct more of their Medicaid beneficiaries into managed care plans, those beneficiaries may be encountering difficulty converting their access to health insurance into access to health care. According to the OIG report Access to Care:  Provider Availability in Medicaid Managed Care, We found that slightly more than half of providers could not offer appointments [&hellip

Residents of Disadvantaged Neighborhoods More Likely to Require Readmission

Medicare beneficiaries living in the most disadvantaged neighborhoods are more likely than others to require readmission to the hospital for problems associated with congestive heart failure, pneumonia, or myocardial infarction. This is one of the findings in a new Annals of Internal Medicine study titled “Neighborhood Socioeconomic Disadvantage and 30-Day Rehospitalization:  A Retrospective Cohort Study.” The study, based on data from 2004 through 2009, compared Medicare readmission rates in different geographic areas using what is called a validated area deprivation index that measures relative socioeconomic disadvantage to identify the most disadvantaged areas.  Researchers concluded that The 30-day rehospitalization rate did [&hellip

Homelessness and Safety-Net Hospitals

Homeless people with serious medical problems are more likely than others to be readmitted to hospitals – and especially, to safety-net hospitals – during their convalescence from illnesses and injuries. This is one of the conclusions in the recently published Journal of Community Health Nursing article “Assessing the Needs for a Medical Respite:  Perceptions of Service Providers and Homeless Persons.” According the study, homeless people lack safe places to convalesce.  Shelters do not suffice, the study found, because they are not open around the clock and lack staff qualified to support recovery.  The homeless also report that their drugs are [&hellip

Feds Release Medicaid DSH “Uninsured” Definition

The Centers for Medicare & Medicaid Services (CMS) has published a new regulation that defines “uninsured” for the purpose of calculating the limit for how much individual hospitals may receive in Medicaid disproportionate share hospital payments (Medicaid DSH). Under federal law, Medicaid DSH payments to hospitals cannot exceed the uncompensated costs of the services those hospitals provide to Medicaid recipients and the uninsured.  In calculating hospital-specific limits, according to the new regulation, … the calculation of uncompensated care for purposes of the hospital-specific DSH limit will include the cost of each service furnished to an individual by that hospital for [&hellip

NAUH Publishes New Study

The National Association of Urban Hospitals today released a new study that examines thefinancial impact on urban safety-net hospitals of health care reform and other cuts in Medicare payments on urban safety-net hospitals. The study, The Disproportionate Impact of Medicare Cuts and Health Care Reform on Urban Safety-Net Hospitals, shows that these cuts – in Medicare disproportionate share payments (Medicare DSH), from productivity adjustments and documentation and coding adjustments, in bad debt reimbursement, in hospital readmissions reduction program penalties, and Medicare sequestration cuts – are taking a significant financial toll on urban safety-net hospitals.  The study documents both the disproportionate [&hellip

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