Noteworthy News

Archive for April, 2016


Low Participation Plagues Dual-Eligibles Demo

A federal demonstration program that seeks to improve care for those eligible for both Medicare and Medicaid is suffering from under-participation. This perspective was presented during last week’s meeting of the Medicare Payment Advisory Commission, the independent federal agency that advises Congress on Medicare payment and policy issues. Among the factors affecting participation have been difficulties identifying eligible participants, resistance from providers, and low provider payments. Because of the low participation, it has been difficult to measure the program’s effectiveness in better coordinating patients’ care. Currently 61 health plans in 12 states participate in the program. Such programs are important [&hellip

Safety Net Still Needed, Study Finds

Despite Affordable Care Act policies that have enabled millions of Americans to obtain health insurance, the health care safety net is still needed. Or so concludes a new report from the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms. For the report A Tale of Three Cities: How the Affordable Care Act is Changing the Consumer Coverage Experience in 3 Diverse Communities, researchers visited and examined conditions in Tampa, Columbus, and Richmond (Virginia), and among their conclusions was: We still need a safety net. Safety net programs in existence before the ACA were expected to become less necessary once the [&hellip

MedPAC Addresses Issues at April Meeting

Last week the Medicare Payment Advisory Commission met in Washington, D.C. On its agenda were the following issues on which MedPAC is advising Congress: the development of a unified prospective payment system for post-acute care improving Medicare Part D Medicare Part B drug and oncology payment policy issues using encounter data for risk adjustment in Medicare Advantage hospice and Medicare spending measuring low-value care preserving access to emergency care in rural areas CMS’s financial alignment demonstration for dual-eligible beneficiaries Go here to find the issue briefs and presentations used during the two-day meeting

Academy Offers Practices to Improve Care for Disadvantaged Patients

The National Academies of Science, Engineering, and Medicine has published a new report that acknowledges the challenges faced by hospitals that care for socio-economically challenged patients and offers suggestions for how to serve those patients more effectively. The report, Systems Practices for the Care of Socially At-Risk Populations, is the second in a projected series of five reports on the subject. The study notes that Emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to [&hellip

New Approaches to Readmissions Reduction Program?

While Medicare’s readmissions reduction program has produced a decline in the number of Medicare readmissions within 30 days of discharge, critics – among them the National Association of Urban Hospitals – argue that the program is unfair to hospitals that serve especially large numbers of low-income patients whose distinct needs pose a greater risk of requiring readmission to address. In a new report, the journal Health Affairs notes that such arguments have given rise to a number of proposals for possible changes in the readmissions reduction program. Among them, the Medicare Payment Advisory Commission …has proposed a revision to the [&hellip

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