Noteworthy News

Archive for March, 2015


State Uses Innovation Funding to Improve Care for Urban Poor

New York’s Medicaid program is taking advantage of federal innovation money to explore new approaches to serving low-income urban Medicaid patients. With the help of Delivery System Reform Incentive Payments (DSRIP), special Medicaid funding from the federal government, caregivers serving Medicaid patients are organizing into accountable care organizations (ACOs) in New York City. Under the experiment, doctors and hospitals join together to serve populations of Medicaid patients. While the doctors are currently paid on a fee-for-service basis, the program’s goal is to move them toward outcomes-based reimbursement, with bonuses paid to providers who achieve specific goals for improving the health [&hellip

340B Program Faces Challenges, Change

A federal program that helps selected health care providers obtain discounted drugs for low-income patients they are serving on an outpatient basis may soon face major changes. The 340B prescription drug pricing program, created more than 20 years ago to help serve low-income individuals, has come under fire in recent years in both the House and the Senate over how qualified, participating providers – disproportionate share hospitals, Federally Qualified Health Centers and their look-alikes, children’s hospitals, critical access hospitals, rural referral centers, and others – use the savings they derive from the program. While there is a general expectation that [&hellip

NAUH Endorses Bill to Address Medicare “Doc Fix” Problem, March 25, 2015

In a letter to members of the House, NAUH has endorsed H.R. 2, the Medicare Access and CHIP Reauthorization Act, which eliminates use of the Medicare sustainable growth rate formula (SGR) to determine Medicare payments to physicians and solves the long-running “Medicare doc fix” problem. See NAUH’s endorsement letter here

Numbers Link Medicaid Expansion, Diabetes Diagnoses

One of the primary arguments made by the National Association of Urban Hospitals in favor of government reimbursement policies that support the work of urban safety-net hospitals is that the patients they serve have had sporadic contact with the health care system over the years and often present with medical problems that go well beyond the immediate reason that brings them to hospitals. Now comes new information that supports that argument. The medical testing company Quest Diagnostics has found that the number of Medicaid patients its testing has found to have diabetes has risen more than 24 percent during two [&hellip

OIG Reiterates Medicare, Medicaid Recommendations

Every year the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) examines the operations of various department offices, programs, and policies and offers recommendations for changes and improvements. Some of those recommendations are adopted and others are not. The OIG annually publishes a document reiterating what it believes to be its most important and potentially useful recommendations that were not adopted, and that publication was just released. Among the Medicare and Medicaid recommendations it has presented again are: Establish accurate and reasonable Medicare payment rates for hospital inpatient services. Establish accurate and reasonable Medicare payment [&hellip

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