Noteworthy News

Archive for March, 2015


MedPAC Offers Recommendations on Payments, More

The federal agency that advises Congress on Medicare payment issues has submitted to Congress its annual recommendations for changes in how Medicare pays providers for the services they deliver to the nation’s seniors. Among the recommendations offered by the Medicare Payment Advisory Commission (MedPAC) for FY 2016 are: The reduction or elimination of differences in rates between physician offices and hospital outpatient departments for selected services. A new prospective per beneficiary payment to replace the Primary Care Incentive Payment that expires at the end of 2015. The repeal and replacement of the sustainable growth rate formula (SGR). An increase in [&hellip

Congress Mulls Another Medicare Doc Fix

With a March 31 deadline looming before Medicare payments to physicians are scheduled to decline more than 20 percent, it appears Congress may be considering permanent repeal of the underlying root of the problem rather than yet another short-term patch. At the heart of the problem is the sustainable growth rate formula, or SGR, that determines how Medicare pays physicians.  For years Congress has applied short-term solutions to the SGR problem and paid for those solutions with short-term spending cuts.  Now it appears congressional leaders are contemplating a permanent repeal of the troublesome formula. The cost of doing so is [&hellip

MedPAC Recommends Changes in Medicare Short Stay Policies

The independent agency that advises Congress on Medicare payment issues has recommended that Congress call on Medicare to revise its policies governing short hospital stays for Medicare patients. At its March 5 meeting in Washington, D.C., staff of the Medicare Payment Advisory Commission (MedPAC) made a presentation on Medicare hospital short stay policy to MedPAC commissioners. Based on the presentation and member deliberations, MedPAC is recommending to Congress that Medicare include observation status when determining whether newly discharged patients are eligible for skilled nursing care; that hospitals be required to notify hospitalized patients if they are under observation only and [&hellip

Safety-Net Hospitals Struggle With Medicare’s Value-Based Purchasing

Safety-net hospitals are more likely than others to fare poorly under Medicare’s value-based purchasing program. Or so concludes a new study published in the journal Health Affairs. Researchers examined the impact of the addition of patient mortality measures to the program in 2014, and according to the abstract of the new study, We found that safety-net hospitals were more likely than other hospitals to be penalized under the VBP program as a result of their poorer performance on process and patient experience scores. In 2014, 63 percent of safety-net hospitals versus 51 percent of all other sample hospitals received payment rate reductions [&hellip

States Turning More to Providers to Fund Medicaid

States are relying more on provider taxes and other sources to raise their share of Medicaid funding, a new study by the U.S. Government Accountability Office (GAO) has found. According to the GAO, state use of such funding rose 21 percent from 2008 to 2012.  Most of the money came from health care provider taxes, provider donations, intergovernmental transfers, and Medicaid certified public expenditures. While the study examined the issue nation-wide it focused on Medicaid financing in three states:  California, Illinois, and New York. To learn more about how states are financing their share of their Medicaid programs and why [&hellip

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