Noteworthy News

Archive for September, 2015


Court Rebuffs HHS on Two-Midnight Rule Pay Cut

A federal court has told the U.S. Department of Health and Human Services that it will have to do more to justify a 0.2 percent cut in inpatient payment rates that is part of the controversial Medicare two-midnight rule. The court decided that in addition to providing a better rationale for the pay cut, Medicare also will need to have a public comment period for that rationale. Medicare had already delayed implementation of the two-midnight rule. To learn more about this court decision, see this McKnight Long-Term Care News article

Better Medicaid Data Needed, Governors Say

States need better data to meet the needs of Medicaid recipients with complex medical needs, according to the National Governors Association (NGA). One of the biggest costs in state Medicaid programs is “super-utilizers”: patients who consume a significant amount of health care services. Although relatively few in number, these patients account for a significant proportion of state Medicaid expenditures. The group’s conclusion is based on the NGA Center for Best Practices’ experience working with seven states to find better ways to meet the needs of these patients with better but less-expensive care. According to the report, Before state leaders can [&hellip

NAUH Talks Medicare DSH With Congressional Committee

Last week representatives of the National Association of Urban Hospitals (NAUH) met with staff of the House Ways and Means Committee’s Health Subcommittee to offer the association’s views on H.R. 3288, the Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act. The bill calls for significant changes in how Medicare makes disproportionate share payments (Medicare DSH) to hospitals. After talking to committee staff about the role Medicare DSH payments play in enabling urban safety-net hospitals to serve their low-income communities, NAUH representatives expressed concern about three aspects of the proposal: its call for a new, permanent, unchanging sum [&hellip

Medicare Readmissions Program Unfair to Safety-Net Hospitals, Study Finds

Medicare’s readmissions reduction program penalizes hospitals based largely on the patients they serve rather than their performance serving them, a new study has concluded. According to the report “Patient Characteristics and Differences in Hospital Readmission Rates,” published in the journal JAMA Internal Medicine, Patient characteristics not included in Medicare’s current risk-adjustment methods explained much of the difference in readmission risk between patients admitted to hospitals with higher vs lower readmission rates. Hospitals with high readmission rates may be penalized to a large extent based on the patients they serve. Among those two dozen socio-economic factors: patient income, education, and ability [&hellip

MedPAC Continues to Work on Post-Acute-Care Policy

The Medicare Payment Advisory Commission (MedPAC) continues to work toward its June 2016 deadline for developing a model for a new, unified payment system for post-acute-care services for Medicare patients. Operating under a mandate from the 2014 IMPACT Act, MedPAC is working to address variations in post-acute-care payments, misalignments between costs and payments, and payments based in part on where services are delivered rather than what services are delivered. MedPAC members discussed the challenges they face and the directions they are looking for improvements at their monthly meeting last week in Washington, D.C. MedPAC’s staff delivered a presentation on the [&hellip

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