Archive for October 2015

Medicare Cuts May be Part of Budget Deal

The agreement between the White House and congressional negotiators on a two-year budget deal and an increase in the federal debt ceiling will be paid for in part with reductions in Medicare payments. Under the reported agreement, negotiators agreed to increase federal spending $80 billion over two years, and that increase will almost certainly need to be offset by spending cuts. The New York Times has reported that “The Medicare savings would come from cuts in payments to doctors and other health care providers.” The budget agreement reportedly did not include specific spending cuts beyond extension of the current two percent Medicare sequestration cuts, although the publication The Hill reports that site-neutral Medicare outpatient payments may be part of the … Read More

Posted in Medicare

Low-Income Workers Rejecting Health Insurance

Low-wage workers offered health insurance by their employers are largely rejecting that option, according to a report in the New York Times. According to the Times, most of the progress in reducing the number of unemployed Americans has been made through Medicaid expansion and subsidies offered through the federal and state health exchanges. As small businesses begin to be required to offer their workers unsubsidized insurance, however, they are finding that most of their lower-wage employees are rejecting the offer. As a result, 7.5 million people last year paid the Affordable Care Act fine for failing to obtain health insurance. A review of the profile of those who choose not to purchase employer-sponsored health insurance found that workers who earn … Read More

Posted in Affordable Care Act

Increases in Medicaid Enrollment Should Slow

Growth in Medicaid enrollment, significant this year and last, should slacken in 2016, according a new Kaiser Family Foundation report. That growth – 8.3 percent in 2014 and 13.8 percent in 2015 – should fall to approximately four percent next year. The upswing is the result of Medicaid expansion authorized by the Affordable Care Act and most of the growth was in states that expanded their Medicaid programs, although in 2015 every state experienced an increase in Medicaid enrollment. Growth in Medicaid spending, too, is expected to decline, from 14.3 percent in 2014 and 13.9 percent in 2015 to a projected 6.9 percent in 2016. To learn more about how, where, and why Medicaid enrollment and spending continue to grow, … Read More

Posted in Affordable Care Act

Patient-Centered Care Needs Closer Scrutiny, Study Says

While the growing emphasis on patient-centered care has turned from a theory into an active tool in the development of public health care policy, a greater emphasis must be placed on cataloguing and examining more closely those efforts. Or so says a new study from the Urban Institute. According to the study, policy-makers need “…a clearer picture of where current policies have already taken us and where they are heading.” The study also notes that “… efforts in HHS and elsewhere in the federal government should be comprehensively catalogued and subjected to the same strategic scrutiny as other care improvement activities” and that “The pace of change also underlines the need for better measures and more information on effective implementation.” … Read More

Posted in Medicare

Members of Congress Seek Increased Medicare Rates

Members of Congress have written to Centers for Medicare & Medicaid Services (CMS) acting administrator Andrew Slavitt asking him to reconsider his agency’s proposal to reduce the rates Medicare will pay providers for outpatient services. In July, CMS proposed reducing those outpatient rates 0.2 percent in calendar year 2016. The letter notes that According to MedPAC, Medicare already pays hospitals less than 88 cents on the dollar for outpatient services and this rule will make that situation worse for our constituents – both hospitals and patients alike. The letter also states that Medicare already pays providers less than the cost of care. Prescribing a negative update to OPPS [note: outpatient prospective payment system] payment rates will only make it more … Read More

Posted in Medicare

GAO Questions Impact of Medicare Value-Based Purchasing Program

Medicare’s value-based purchasing program may not be having much of an impact on the quality of care hospitals provide, according to a new report by the U.S. Government Accountability Office. According to a GAO summary of its report Hospital Value-Based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of-Care Trends, GAO’s analysis found no apparent shift in existing trends in hospitals’ performance on the quality measures included in the HVBP [note: hospital value-based purchasing] program during the program’s initial years. The agency did note, however, that …shifts in quality trends could emerge in the future as the HVBP program continues to evolve. The study also evaluated how safety-net hospitals fare under the program. GAO … Read More

Posted in Uncategorized

Study Considers How Best to Prevent Readmissions

A five-year study performed by researchers from the Yale School of Public Health has found that while many hospitals have successfully reduced the rate of readmission for their Medicare patients, few specific strategies have emerged as best practices for tackling this challenge. In fact, only one strategy appears to be universally effective: discharging patients with their follow-up appointments already made. Beyond that, researchers found that hospitals lowered their readmission rates by employing a number of tools and that most successful hospitals employed at least three such tools – although which tools they employed differed and more tools did not produce better results. Hospitals have been working to lower their readmissions in response to Medicare’s hospital readmissions reduction program, which imposes … Read More

Posted in Medicare

Hospitals, Especially Safety-Net Hospitals, Struggle With Heart Failure Readmissions

For all the emphasis on reducing readmissions to hospitals, providers continue to struggle to prevent readmissions of patients suffering heart failure. Or so concludes a new study published in the Journal of Cardiac Failure. According to the study, there has been only a slight reduction in readmissions rates for heart failure patients over the past four years. In addition, Fierce Healthcare reports that …2014 research revealed that safety-net hospitals and those with largely low-income patient populations are at particular risk for heart failure readmissions; patients from lower-income neighborhoods, researchers found, were nearly 17 percent more likely to be readmitted within six months of discharge. This finding supports the Safety-Net Association of Pennsylvania’s long-time contention that the distinct challenges Pennsylvania’s safety-net … Read More

Posted in Medicare, Uncategorized

Better Medicaid Data Needed, Governors Say

States need better data to meet the needs of Medicaid recipients with complex medical needs, according to the National Governors Association (NGA). One of the biggest costs in state Medicaid programs is “super-utilizers”: patients who consume a significant amount of health care services. Although relatively few in number, these patients account for a significant proportion of state Medicaid expenditures. The group’s conclusion is based on the NGA Center for Best Practices’ experience working with seven states to find better ways to meet the needs of these patients with better but less-expensive care. According to the report, Before state leaders can begin to address their super-utilizer populations, they first need to understand who those patients are, how they use the health … Read More

Posted in Pennsylvania Medicaid policy
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