Noteworthy News

Archive for July, 2016


ACA Slowly, Surely Improving Health Status

A new survey has found that the combination of Affordable Care Act-driven enhanced access to health insurance and improved performance by health care providers is producing better health status in communities across the U.S. The survey looked at health status in 306 regional health care markets based on factors such as access to care, quality, avoidable hospital use, health care costs, and health outcomes found modest improvements in these areas and attributed those improvements to expanded access to health insurance and government quality programs introduced through the Affordable Care Act. The gains the survey documented occurred from 2011 through 2014. [&hellip

Report to CMS on Risk Adjustment of Medicare Hospital Payments

The National Academies of Sciences, Engineering, and Medicine has issued its latest report to the Centers for Medicare & Medicaid Services on how to adjust Medicare payments to hospitals based on the socio-economic risk factors hospitals’ patients pose. At the request of CMS, the Academies created an expert committee to …identify criteria for selecting social risk factors, specific social risk fascinators Medicare could use, and methods of accounting for those factors in Medicare quality measurement and payment applications. The committee created for this purpose viewed its goal to be  …to guide the selection of social risk factors that could be [&hellip

Medicaid Directors Seek Help With Hepatitis C Drugs

The combination of new cures for hepatitis C, the high cost of those cures, and the large population of low-income people suffering from the disease has the nation’s Medicaid directors asking for help from Congress. “Medicaid programs have decades of experience providing care to medically complex patients, but Hepatitis C is the first real case where a very high per patient cost has been combined with a very large patient population needing treatment,” the National Association of Medicaid Directors declared in a recent news release. To help them address the high cost of providing a new generation of drugs to [&hellip

Insurance Expansion and Health Status

A new study suggests that the Affordable Care Act’s insurance and Medicaid expansion is improving the health of both Medicaid recipients and the uninsured. According to the study, the health of Medicaid recipients and the uninsured was better in 2014 than in 2013. Many patients of the nation’s private, non-profit urban safety-net hospitals have benefited from the improved access to health insurance and especially the expansion of Medicaid eligibility made possible by the Affordable Care Act. To learn more, see the article “Changes In Health Status And Care Use After ACA Expansions Among The Insured And Uninsured” here, on the [&hellip

CMS Fills in the Blanks on Site-Neutral Payments

When Congress passed a budget bill last fall calling for the introduction of site-neutral payments for Medicare-covered outpatient services, hospitals wondered how this might affect their current provider-based outpatient facilities and their plans for future facilities or acquisitions. Now they have some answers. Last week the Centers for Medicare & Medicaid Services put regulatory flesh on the bones outlined by Congress in a 764-page proposed regulation that addresses what hospital-based outpatient facilities and services will be covered by the site-neutral payment rule and which will not. Interested parties have until September 6 to submit formal comments to CMS about the [&hellip

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