Noteworthy News

Archive for February, 2015


Insurance Expansion Won’t Hurt Access to Primary Care, Study Finds

Fears that significant increases in the numbers of Americans with health insurance as a result of Affordable Care Act policies would overwhelm the health care system and lead to access to care problems are unfounded, according to a new Commonwealth Fund report. According to the new report “How Will the Affordable Care Act Affect the Use of Health Care Services?”, the country’s current supply of primary care providers is more than adequate to meet any demand for primary care services.  The study found that … primary care providers will see, on average, 1.34 additional office visits per week, accounting for [&hellip

States Seek to Reduce ER Use Among Medicaid Patients

Even though the rate at which non-Medicaid recipients inappropriately use hospital emergency rooms exceeds the rate of inappropriate use among Medicaid patients, a number of states are launching efforts to reduce ER overuse among their Medicaid recipients. Medicaid patients currently use – as distinguished from inappropriately use – hospital ERs at twice the rate of privately insured patients, typically for a number of reasons:  they are less healthy than insured patients; they have a more difficult time finding primary care physicians who will treat them; and they have jobs that prevent them from going to doctors during ordinary office hours. [&hellip

Administration Blocks No-Hospitals Insurance Plans

Health insurance plans that do not include hospital benefits fail to meet employers’ obligations under the Affordable Care Act and will leave companies that provide such insurance vulnerable to fines of $3000 a year for every worker covered by such a plan, the Centers for Medicare & Medicaid Services (CMS) announced last week. But in recognition that some employers had arranged such coverage well in advance, the federal government is permitting companies that committed to such plans by November 4 to use them for the next year, after which they must be replaced.  In addition, employees who seek to compensate [&hellip

Proposal for Improving Medicare Physician Payments

Last year, Congress considered shifting Medicare’s payments to physicians from their fee-for-service foundation to a value-based purchasing approach as part of its attempt to address the Medicare sustainable growth rate (SGR) formula problem (the “Medicare doc fix”). With that problem once again facing Congress, the Urban Institute has published a new paper outlining how to make that transformation. That paper, “Medicare Physician Payment Reform:  Securing the Connection Between Value and Payment,” can be found here

MedPAC Looks at New Quality Measures

Amid Medicare’s effort to encourage hospitals to improve the quality of the care they deliver, the Medicare Payment Advisory Commission (MedPAC) looked at new possible quality measures to contribute to that effort during a recent meeting in Washington, D.C. Noting that current Medicare quality reporting measures are burdensome to track and do not have a strong correlation with better outcomes, MedPAC commissioners looked at a measure called “healthy days at home,” which is defined as “days in set time period that a given population is alive and did not have a non-ambulatory interaction with the health care system.” The purpose [&hellip

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