Noteworthy News

Archive for April, 2015


MedPAC Calls for End of “Two-Midnight Rule”

The independent agency that advises Congress on Medicare payment issues has recommended that Medicare eliminate its controversial two-midnight rule. At its recent meeting in Washington, D.C., the Medicare Payment Advisory Commission (MedPAC) also recommended that Medicare focus RAC (Recovery Audit Contractor) audits on hospitals with the highest numbers of short inpatient stays, shorten the look-back period for audits, modify the three-day rule for skilled nursing facility coverage, and require hospitals to inform patients when their stay has been classified as observation status rather than inpatient status. Learn more about MedPAC’s recommendation in this Fierce Healthcare news report and go here [&hellip

Looking at Payment and Delivery System Reform

Last fall the Robert Wood Johnson Foundation brought together grant recipients and national experts to talk about health care payment and delivery system reform design and implementation issues. Now, the foundation has released a brief paper that addresses what the experts consider to be the three greatest challenges in the pursuit of such reform: Aligning alternative payments with clinician compensation Considering social determinants of health in payment reform models Repurposing hospital resources The paper also takes a look at whether health care payments should be subject to risk adjustment to reflect the social and economic barriers to better health and [&hellip

Medicare-Medicaid Coordination Office Reports to Congress

The federal agency created by the Affordable Care Act to facilitate better coordination of federal benefits for those eligible for both Medicare and Medicaid has issued its annual report on its activities to Congress along with a number of recommendations for future policy changes. In addition to reporting on its work over the past year, the Medicare-Medicaid Coordination Office recommended that Congress consider legislation to: Create a pilot to expand the PACE program (Programs of All-Inclusive Care for the Elderly) to people between the ages of 21 and 55. Ensure retroactive Medicare Part D coverage for newly eligible low-income beneficiaries. [&hellip

MACPAC Looks at Value-Based Purchasing in Medicaid

At a recent meeting of the Medicaid and CHIP Payment and Access Commission (MACPAC), the agency’s staff made a presentation on how different states are pursuing value-based purchasing in their Medicaid programs. The presentation focused on current efforts in three states: Connecticut, Maryland, and Oklahoma, describing the policy approach those states have taken, the models they employ, the implementation challenges they have faced, and how they evaluate the effectiveness of their efforts. Because they care for so many Medicaid patients, the nation’s urban safety-net hospitals have a special interest in new approaches to Medicaid payment policy. Find the MACPAC presentation [&hellip


The legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and state governments on Medicaid and Children’s Health Insurance Program (CHIP) issues recently took a look at a relatively new type of supplemental Medicaid funding. The Medicaid and CHIP Payment and Access Commission (MACPAC) is examining Delivery System Reform Incentive Payment Programs (DSRIP), which it describes as a new type of supplemental payment that provide incentive payments for hospitals and other providers to undertake delivery system transformation efforts. Currently operating in California, Texas, Massachusetts, Kansas, New Jersey, and New York, DSRIP projects are led by [&hellip

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