Noteworthy News

Archive for November, 2016


MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss a number of issues on which it is contemplating advising Congress. Those issues were: the role of Medicare policy in provider consolidation stand-alone ERs payments from drug and device manufacturers to physicians and teaching hospitals determining benchmarks and beneficiary premiums under a premium support system for Medicare Medicare outlier payments and hospital charging practices Medicare Advantage: calculating benchmarks and coding intensity population-based outcome measures: healthy days at home and potentially preventable admissions and ER visits Go here to see the issue briefs and presentations associated with MedPAC commissioners’ discussions [&hellip

States Exploring Deviations from ACA Standards

A number of states are considering pursuing waivers from selected requirements of the Affordable Care Act in the name of health care innovation. Section 1332 of the 2010 health care reform law permits states, with federal approval, to implement different approaches to providing their residents with quality, affordable health care that fall outside the restrictions of Affordable Care Act requirements so long as those different approaches provide comparable coverage and do not increase federal costs. These state innovation waivers, also commonly referred to as section 1332 waivers, are available to take effect as of January 1, 2017 and a number [&hellip

More Evidence Supports Shortcomings of Medicare Readmissions Penalties

A new study supports the belief that Medicare’s hospital readmissions reduction program is unfair to hospitals that serve especially large numbers of low-income patients. A study published in the journal Surgery found that hospitals that serve larger numbers of minority patients have higher 30-day and 90-day readmissions rates for patients who undergo colorectal surgery than other hospitals. According to the study, 65 percent of the increased risk of readmission can be attributed to “patient factors,” as opposed to hospital factors, with study data suggesting that such factors include income, race, and insurance status. NAUH has long maintained that Medicare’s hospital [&hellip

Feds to Target Urban Areas for Health Insurance Open Enrollment

As part of a campaign to encourage more Americans to obtain health insurance during the open enrollment period of the federal insurance marketplace and state marketplaces, the Centers for Medicare & Medicaid Services has identified 15 large urban markets where it intends to focus a great deal of effort on encouraging people to obtain health insurance. Those markets are: Atlanta, GA Charlotte, NC Chicago, IL Dallas-Fort Worth, TX Detroit, MI Houston, TX Miami-Fort Lauderdale, FL Northern New Jersey Orlando-Daytona-Melbourne, FL Philadelphia, PA Phoenix, AZ Salt Lake City, UT San Antonio, TX Louis, MO Tampa-St. Petersburg, FL These areas are being [&hellip

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