Noteworthy News

Archive for June, 2015


NAUH Comments on Proposed Medicare Regulation (Part 1 of 4)

On April 30, the Centers for Medicare & Medicaid Services (CMS) published a 1500-page draft regulation detailing how it proposed paying hospitals for the inpatient care they provide to their Medicare patients in FY 2016 and invited comment on its proposal from stakeholders and interested parties. Last week, the National Association of Urban Hospitals provided its written comments in a letter to CMS. Over the next four days NAUH presents those comments in this space: Today: Medicare DSH Tomorrow: Hospital inpatient rates Wednesday: the hospital readmissions reduction program Thursday: short hospital stays and outliers Medicare DSH NAUH would like to [&hellip

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has released its second of two 2015 reports to Congress on Medicaid and the Children’s Health Insurance Program (CHIP). In the report, the agency looks at the role of Medicaid in providing behavioral health services; examines Medicaid coverage of dental services for adults; contemplates the intersection between Medicaid and child welfare; and considers whether Delivery System Reform Incentive Payment (DSRIP) programs are a legitimate means of fostering health care delivery reform or have become just a means of states’ supplementing the Medicaid payments they make to providers. Find a summary of [&hellip

MedPAC Sends Annual Report to Congress

As required by law, the independent federal agency that advises Congress on Medicare payment issues has transmitted its annual report to Congress with its observations, analysis, and policy recommendations.  The June 2015 report of the Medicare Payment Advisory Commission (MedPAC) addresses the following subjects:  hospital short-stay policy payment policies for Part B drugs value-based incentives for Part B drugs polypharmacy and opiod use risk-sharing in Part D synchronizing policy across Medicare’s various payment models next steps in measuring quality the next generation of Medicare beneficiaries Find a fact sheet on the MedPAC report here and the complete report itself here. [&hellip

Variations on Medicaid Expansion

While most states that have taken advantage of the Affordable Care Act’s Medicaid expansion have simply expanded their existing Medicaid programs to incorporate the newly eligible, six states have taken a different path, pursuing what are known as section 1115 waivers – waivers of formal Medicaid requirements – to expand their Medicaid programs in different ways. Typically, those different ways involve coverage modeled on private sector insurance practices, including requiring the newly eligible to choose from among approved managed care plans on the private market; the elimination of some traditional Medicaid benefits; the imposition of work requirements and higher premiums; [&hellip

“Medical Homes” Shows Potential in New Study

While the “medical homes” approach to coordinating care has received mixed reviews in a number of studies, a new report suggests that the approach still has potential – under the right conditions. According to a study published in JAMA Internal Medicine, the medical homes model, when accompanied by “substantial financial incentives” for participating doctors, shows potential for improving the quality of care patients receive while reducing emergency room use and inpatient admissions. The findings are based on claims data from 17,000 patients from medical practices participating in the Pennsylvania Chronic Care Initiative. To learn more about the findings, go here [&hellip

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