NQF to Medicaid: Do a Better Job of Addressing Social Determinants of Health
State Medicaid programs need to do a better job of measuring and addressing the social risks their patients face, the National Quality Forum has asserted in a new report. To do so, NQF concluded, state Medicaid programs should “…work more [...]
Docs Not Scoring Performance Bonuses
Relatively few physicians will receive Medicare pay-for-performance bonuses under Medicare’s value-based modifier program in 2018. The question now is whether this is because of uninspiring performance or indifference to the program. Of the approximately 1.1 million clinicians who participate in [...]
Medicaid in the Spotlight
State-option work requirements. A cap on federal spending. New flexibility for states to address eligibility, benefits, and provider payments. Rolling back the Affordable Care Act’s eligibility expansion. Medicaid is under the policy microscope in Washington these days in ways it [...]
Safety-Net Hospitals Under the Gun
Safety-net hospitals across the country - including private safety-net hospitals - face a new challenge: adjusting to several cuts in the supplemental payments they receive from the federal government to help them serve the low-income residents of the communities in [...]
MedPAC Meets
Last week the Medicare Payment Advisory Commission held two days of public meetings in Washington, D.C. During the sessions MedPAC, a non-partisan legislative branch agency that advises Congress on Medicare payment issues, addressed the following subjects: a Medicare Advantage status [...]
A New Use for Section 1115 Medicaid Waivers?
Historically, states have pursued section 1115 Medicaid waivers as a means of expanding Medicaid eligibility. But the Centers for Medicare & Medicaid Services now appears to be looking at granting 1115 waivers to help states reduce their Medicaid populations. According [...]
Administration Lays Groundwork for Medicaid Work Requirements
The Centers for Medicare & Medicaid Services has issued guidelines for states interested in adding a work requirement component to their Medicaid programs. With nearly a dozen states applying to implement controversial Medicaid work requirements, CMS has issued a guidance [...]
NAUH Seeks Action on Medicaid DSH, 340B
The National Association of Urban Hospitals has written to leaders of the House and Senate asking them to reverse implementation of Affordable Care Act-mandated cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to state and to block implementation of [...]
CMS Unveils New Bundled Payment Program
The Centers for Medicare & Medicaid Services has announced the launch of a new bundled payment model called “Bundled Payments for Care Improvement Advanced.” Under this new program – participation in which will be voluntary – participants can, as CMS [...]
E&C Calls for Action on 340B
The section 340B prescription drug program has flaws and needs change, a report by the House Energy and Commerce Committee has concluded. The program, which requires pharmaceutical companies to provide discounts on prescription drugs to be dispensed on an outpatient [...]
