Entries by NASNH Administrator

ACOs Show Encouraging Signs

Provider groups that just completed their first year in Medicare’s ACO programs are showing encouraging signs of producing health care savings. In all, the Centers for Medicare & Medicaid Services (CMS) reports $380 million in savings for first-year participants.  Nearly half of the ACOs participating  in the Shared Savings Program had lower spending than projected […]

CMS Offers Advice on Managing Expected Upsurge in ER Visits

With Medicaid enrollment rising because of eligibility changes introduced through the Affordable Care Act, hospital emergency rooms expect to see an increase in the number of emergency room visits as new Medicaid enrollees seek care for long-neglected health problems. In anticipation of this rise in ER visits, the Centers for Medicare & Medicaid Services (CMS) […]

MedPAC Endorses Site-Neutral Payments

MedPAC has recommended to Congress that Medicare equalize the rates paid to hospital outpatient departments and private physicians’ offices for many outpatient services. Currently, hospital outpatient departments are paid more than physician offices for many Medicare-covered services. MedPAC, which advises Congress on Medicare payment issues, called for reducing or eliminating current fee differentials. While MedPAC’s […]

MedPAC Recommends Raise for Hospitals

The independent agency that advises Congress on Medicare payment issues has recommended a 3.25 percent increase in Medicare payments to hospitals for inpatient and outpatient services in FY 2015. The Medicare Payment Advisory Commission (MedPAC) also recommended an increase of 5.25 percent if the two percent Medicare sequestration cut is still in effect when the […]

Medicare Appeals Go on Back Burner

Faced with a backlog of more than 350,000 appeals of claims decisions, Medicare has announced that that it will suspend acting on new requests for appeals hearings made by hospitals, doctors, nursing homes, and other providers for approximately two years. During that time, the federal Office of Medicare Hearings and Appeals will continue to hear […]

The Time May Have Arrived for a Permanent “Doc Fix”

Congress appears serious about addressing a long-running problem:  the need for an annual “Medicare doc fix” to address the problem stemming from the use of the sustainable growth rate formula, or SGR, to determine Medicare payments for physician services. For years, application of the SGR called for reductions in Medicare payments to doctors, forcing Congress […]

Safety-Net Hospitals Hurt More by Readmissions Reduction Program

Hospitals that care for large numbers of low-income seniors are disproportionately harmed by Medicare’s hospital readmissions reduction program, according to a new study. According to the study, Both patient dual-eligible status and a hospital’s dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid […]

Medical Homes Model Showing Potential

The “medical homes” model for providing health care is showing promise as a way of reducing the cost of care, reducing utilization of unnecessary medical services, improving access to care, and improving population health. These are among the findings in a meta-study by the Patient-Centered Primary Care Collaborative.  The study brings together findings from 21 […]