Noteworthy News

Archive for July, 2016


Lessons in Serving Dual Eligibles

A new report examines the efforts of health plans to improve the delivery and coordination of care for dual eligibles: individuals covered by both Medicare and Medicaid. This population has received growing attention from policy-makers, including the Centers for Medicare & Medicaid Services through its 2011 Financial Alignment Initiative that seeks to test new models of working with this difficult-to-serve population. Now, the Center for Health Care Strategies has reviewed how 14 different health plans approached this challenge. It found that the plans generally: supported individuals in the community by addressing housing and other social determinants of health and by [&hellip

CMS Proposes FY 2017 Outpatient Payments

The Centers for Medicare & Medicaid Services has revealed how it proposes paying hospitals for Medicare-covered outpatient services in 2017. Among other matters, the 764-page proposed regulation addresses: proposed rate increases for outpatient and ambulatory surgery center services; new site-neutral outpatient payment policies; changes in the value-based purchasing program; changes in hospital outpatient quality reporting requirements; electronic health record policies; and changes in ambulatory surgical center quality reporting requirements. NAUH members have received a detailed memo describing the proposed policies.  Representatives of other urban safety-net hospitals may request a copy of that memo by clicking on the “contact us” link [&hellip

A Closer Look at Socio-Economic Risk Factors

The National Association of Urban Hospitals often points to the socio-economic status of the patients its members serve as constituting one of the greatest challenges urban safety-net hospitals face. That challenge typically takes two major forms: how to serve such patients more effectively and how to encourage public officials to shape government (Medicare and Medicaid) reimbursement policies that reflect this distinct challenge and treat such caregivers fairly. Now, the National Academy of Medicine has taken a closer look at the social determinants that play such a major role in community health and in the health of the residents of the [&hellip

New Approach to Super-Utilizers: Free Housing

A Chicago hospital is experimenting with a new way of serving its most frequent uninsured ER visitors: arranging for free housing. The University of Illinois Hospital has found that many of its most frequent ER patients, while suffering from numerous and chronic medical problems, turn to its ER for overnight accommodations during harsh weather. Under a pilot program, the hospital is spending $1000 a month to put its homeless super-utilizers into free housing. With overnight hospital stays for uninsured patients costing $3000, the program offers the potential for significant savings for the hospital. In addition to free housing, participating patients [&hellip

MedPAC: Make Docs Prove They Deserve Extra Pay

Medicare alternative payment programs should require doctors to prove they deserve the increased fees associated with such program, according to the Medicare Payment Advisory Commission. Participating in such programs alone should not be enough to earn physicians larger payments, MedPAC wrote in its annual report to Congress. Instead, alternative payment programs should be structured to demonstrate that physicians’ participation improves the quality of care their patients receive, reduces Medicare costs, or both. Without such a requirement, increased payments could become embedded into the system as an added cost without providing added value. To learn more about what MedPAC has proposed [&hellip

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