Noteworthy News

Archive for April, 2016


CMS Unveils New Medicaid Managed Care Regulation

For the first time in more than 20 years, the federal government is introducing major changes in how it regulates Medicaid managed care. The Centers for Medicare & Medicaid Services describes the 1425-page rule as aligning Medicaid managed care with other health insurance programs, updating how states purchase managed care services, and improving beneficiaries’ experience with Medicaid managed care. To learn more about what CMS has proposed, go here to see the rule itself. Go here to see CMS’s news release accompanying the new regulation. Go here to (under the link “final rule”) to find nine fact sheets summarizing key aspects of the new regulation. And [&hellip

Do Medicare Patient Satisfaction Surveys Foster Opioid Abuse?

A coalition of physicians and medical providers has questioned whether Medicare’s patient satisfaction surveys indirectly encourage physicians to prescribe opioids to help their patients with pain problems. The New York Times reports that coalition participants …filed a petition Wednesday with the federal agency that administers Medicare and Medicaid, the government health programs for the elderly, disabled and poor. The letter asks that officials eliminate certain pain-related questions from patient-satisfaction questionnaires, such as: “During this hospital stay, how often was your pain well controlled?” The groups argue that such questions inadvertently encourage aggressive use of painkillers to maintain high patient-satisfaction metrics. [&hellip

Could Housing Support Help Medicaid Behavioral Health Patients?

Amid indications that assisting with permanent supportive housing can be a cost-effective, evidence-based way of helping to address the behavioral health needs of some Medicaid recipients, housing and behavioral health groups are beginning to take a closer look at how Medicaid resources might be used to help support such housing. In a new report, the National Council for Behavioral Health examines the possibility of using Medicaid resources to finance the delivery of services in supportive housing for Medicaid beneficiaries facing behavioral health challenges. The report examines the policy context for developing integrated permanent supportive housing options in state Medicaid programs; [&hellip

Readmissions Reduction Target Too High?

Medicare’s goal of reducing hospital readmissions 20 percent – a key aspect of its hospital readmissions reduction program – may be too ambitious, researchers have concluded after evaluating the results of a special Connecticut effort to reduce readmissions. In that program, a new approach to reducing readmissions tested on 10,000 older patients considered at high risk of readmissions employed interventions, transition support, education, follow-up telephone calls, and assistance finding community resources and assistance. The result? It cut Medicare hospital readmissions nine percent – less than half the 20 percent goal Medicare has set. The study’s creators concluded that Our analysis [&hellip

Hospitals Turn to Community Health Workers to Prevent Readmissions

It’s a new twist on an old concept: employ peers of low-income patients to go out into the community and work with those recently hospitalized to ensure that they are getting the care and assistance they need to recover from their illnesses and injuries. Traditionally employed by local health departments and other government agencies, community health workers are increasingly being hired by hospitals to reach out to challenging patients and help prevent readmissions to the hospitals for which Medicare (through its hospital readmissions reduction program), and increasingly state Medicaid programs as well, penalize them. And the early results are encouraging: [&hellip

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