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MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [&hellip

Overutilization of ERs May Not be as Great as Perceived

Far fewer hospital emergency room visits are for medical problems better addressed in other settings, according to a new study. In a review of six years worth of data encompassing 424 million ER visits, researchers found that only 3.3 percent of those visits were truly “avoidable,” with the avoidable visits mostly involving problems ERs are not equipped to address, such as dental and mental health issues. This finding flies in the face of the conventional wisdom that people turn too quickly to hospital ERs for routine medical problems or use ERs because they lack access to more appropriate care. Learn [&hellip

Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017:  approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments.  Forty-eight [&hellip

CMS Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services. The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states. The cuts were established in the [&hellip

Urban Hospitals and Community Needs Assessments

A new study evaluates the degree to which non-profit urban hospitals are addressing the issue of health inequities in their Affordable Care Act-mandated community needs assessments. The assessments are part of a requirement for hospitals to retain their tax-exempt status, and the study examined the community needs assessments of 179 hospitals in 28 cities to identify how many explicitly or implicitly address health equity concerns.  The study also determined how many outlined future hospital strategies designed to address health equity issues. All private, non-profit urban safety-net hospitals are subject to this requirement. Learn more about how hospitals are responding to [&hellip

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