Noteworthy News

Archive for December, 2016


New Approach to Helping Patients With Complex Needs

Five foundations have joined forces to pursue new approaches to serving patients with complex medical needs. The Commonwealth Fund, the John A. Hartford Foundation, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, and The SCAN Foundation engaged the Institute for Healthcare Improvement to identify promising ways of better serving patients with complex medical needs. Many such patients, the foundations believe, have adequate access to medical care yet struggle to find the coordination needed between medical, behavioral, and social services to stay well and avoid costly hospitalizations. The group’s first public product is The Playbook, which it describes as [&hellip

MedPAC Talks Payments

At public meetings in Washington, D.C. last week, members of the Medicare Payment Advisory Commission discussed the adequacy of current Medicare payments and whether they need updating in the next fiscal year. Among the payment areas MedPAC reviewed were inpatient services, outpatient services, physician and health professional services, ambulatory surgical center services, skilled nursing facilities, home health services, inpatient rehabilitation hospitals, long-term-care facilitiies, outpatient dialysis services, and hospices. Find the issue briefs and presentations used to guide these discussions here, on MedPAC’s web site

A Look at Medicaid’s Immediate Future

With a new president taking office in January who vows to repeal and replace the Affordable Care Act, it is not clear what will happen to Medicaid, which currently covers 73 million Americans. A new paper from the Kaiser Family Foundation looks at some of the major questions that will arise in the coming months, including: How would ACA repeal affect Medicaid? What would changes in the financing structure mean for Medicaid? How could Medicaid be changed through administrative actions? For this and more, go here to see the Kaiser paper “Key Medicaid Questions Post-Election.”

Urban Hospitals Fare Poorly in Federal Hospital Ratings

Urban hospitals have lower scores than their non-urban counterparts in the Centers for Medicare & Medicaid Services’ Overall Hospital Star Ratings. And a new report in JAMA Internal Medicine explains why. An analysis of CMS’s latest hospital ratings examined conditions that make cities “stressed” – things like poverty, unemployment, high divorce rate, the health of residents, and more – and found that the higher a stress rating assigned to a city, the lower its hospitals rated in the CMS Hospital Star Ratings. In seeking an explanation for this finding, the study suggested that …the star rating component measures may be [&hellip

Medicaid Supplemental Payments Set to Evolve

New health care delivery and reimbursement systems and new federal regulations will result in changes in how states deploy their Medicaid resources through supplemental payments in the coming years. A new Commonwealth Fund report describes the kinds of supplemental Medicaid payments states currently make to hospitals – such as disproportionate share and upper payment limit payments – and notes the differing degree to which individual states use such supplemental payments. It also describes how those supplemental payments may be restructured in the coming years to foster greater use of value-based purchasing and to reward achieving state-created quality goals through new [&hellip

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