Noteworthy News

Archive for September, 2016


Senate May Tackle Socio-economic Risk Adjustment

With a House bill to adjust Medicare payment penalties based upon the socio-economic challenges posed by the patients some hospitals serve folded into a House bill that passed in June, the Senate may take up this issue during its fall session. Health economists, policy experts, and providers generally agree that the performance of hospitals that serve especially large numbers of low-income patients is affected in a number of areas, including Medicare readmissions, meeting value-based purchasing criteria, and others. And while the Centers for Medicare & Medicaid Services acknowledges the challenge, the agency has rejected calls for risk adjustment so far, [&hellip

NAUH Urges Congress to Assist With Medicare Outpatient Regulation

Last year Congress passed the Bipartisan Budget Act, which mandated site-neutral Medicare outpatient payments. The Centers for Medicare & Medicaid Services has proposed a new regulation implementing this policy that NAUH believes will detract from the ability of urban safety-net hospitals to bring much-needed outpatient care to their communities. NAUH submitted extensive comments to CMS about this proposed regulation; see them here. NAUH especially objects to: limits on the ability of hospitals with existing hospital-based outpatient departments to rebuild or relocate those facilities without losing their hospital-based status; limits on hospitals with existing hospital-based outpatient departments expanding those departments and [&hellip

Federal Medicaid Per Capita Spending Limits?

As they have in the past, some members of Congress have suggested of late that Medicaid might benefit from being transformed into a program with limited spending per capita: that is, such an approach would limit the amount of money the federal government would provide to states on a per capita basis. Such an approach would almost certainly have serious implications for private, non-profit urban safety-net hospitals. What issues would need to be addressed to develop such an approach? What data would be needed? Earlier this year the chairmen of the Senate Finance Committee and the House Energy and Commerce Committee [&hellip

New ACO Model Targets Social Determinants of Health

The federal government is altering a previously announced accountable care organization model to help it target the social determinants of health of the patients it serves. The Accountable Health Communities model, launched by the Centers for Medicare & Medicaid Services and the Center for Medicare and Medicaid Innovation in January, has been modified to target “community-dwelling Medicare and Medicaid beneficiaries with unmet health-related social needs.” According to a CMS fact sheet, The foundation of the Accountable Health Communities Model is universal, comprehensive screening for health-related social needs of community-dwelling Medicare, Medicaid, and dual-eligible beneficiaries accessing health care at participating clinical [&hellip

NAUH Comments on Proposed Medicaid DSH Regulation

The National Association of Urban Hospitals has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments. In particular, NAUH opposes the manner in which CMS would treat payments from Medicare and third-party payers made on behalf of Medicaid-eligible individuals. In NAUH’s view, the letter notes, …the hospital-specific DSH limit has come to penalize the very hospitals – including private urban safety-net hospitals – that Medicaid DSH payments were designed to support. The NAUH letter explains that What troubles NAUH at [&hellip

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