CMS Proposes Medicaid DSH Rule
The Centers for Medicare & Medicaid Services has proposed a new rule that would clarify the basis for eligible hospitals’ Medicaid disproportionate share hospital payments (Medicaid DSH). Individual hospitals’ Medicaid DSH payments are based on their uncompensated care costs and [...]
Docs Less Likely to Participate in ACOs in Disadvantaged Communities
A new study has found that physicians who practice in areas with higher proportions of low-income, uninsured, less-educated, disabled, and African-American residents are less likely than others to participate in accountable care organizations. If ACOs ultimately are found to improve [...]
Medicare Readmissions Penalties Rise
Medicare will impose more than $500 million in penalties in FY 2017 on hospitals that readmit too many Medicare patients within 30 days of their discharge from the hospital. The penalties, part of Medicare’s hospital readmissions reduction program, represent a [...]
CMS Urges Improvements in Care for Physically, Mentally Disabled
New guidance issued by the Centers for Medicaid Services outlines how states can make better use of home care in serving physically and mentally disabled Medicaid beneficiaries. Those steps include establishing open registries of home care workers; establishing qualifications for [...]
Feds Announce Process for Phasing Out Medicaid Pass-Through Payments
A number of states supplement the Medicaid revenue of high-volume Medicaid hospitals – and draw down additional federal Medicaid matching funds – by making special pass-through payments through Medicaid managed care organizations. Such payments are often used to distribute the [...]
Access to Primary Care Better for Medicaid Patients in Private Plans
Medicaid beneficiaries enrolled in commercial, marketplace health plans have better access to appointments for primary care services than those enrolled in traditional state Medicaid programs. Or so concludes a study conducted by the Leonard Davis Institute of Health Economics. According [...]
Report: Uncompensated Care Payments Insufficiently Aligned With Uncompensated Costs
Some of the payments Medicare makes to hospitals to help them with their uncompensated care costs are not well-aligned with actual hospital uncompensated care costs, the U.S. Government Accountability Office has concluded. In a new report based on FY 2013 [...]
New Series Examines Serving High-Need, High-Cost Patients
The Commonwealth Fund is launching a new series of case studies describing “innovative programs designed to address the needs of the nation’s high-need, high-cost patients, a group that accounts for a disproportionate share of health care spending.” Among the types [...]
ACA Slowly, Surely Improving Health Status
A new survey has found that the combination of Affordable Care Act-driven enhanced access to health insurance and improved performance by health care providers is producing better health status in communities across the U.S. The survey looked at health status [...]
Report to CMS on Risk Adjustment of Medicare Hospital Payments
The National Academies of Sciences, Engineering, and Medicine has issued its latest report to the Centers for Medicare & Medicaid Services on how to adjust Medicare payments to hospitals based on the socio-economic risk factors hospitals’ patients pose. At the [...]
