Medicare Readmissions Down Almost Everywhere
Hospitals in 49 of the 50 states have reduced their Medicare readmissions since the federal health care program introduced its readmissions reduction program in 2010. Only hospitals in Vermont have failed to cut readmissions. Nationally, readmissions fell more than five [...]
Senate May Tackle Socio-economic Risk Adjustment
With a House bill to adjust Medicare payment penalties based upon the socio-economic challenges posed by the patients some hospitals serve folded into a House bill that passed in June, the Senate may take up this issue during its fall [...]
NAUH Urges Congress to Assist With Medicare Outpatient Regulation
Last year Congress passed the Bipartisan Budget Act, which mandated site-neutral Medicare outpatient payments. The Centers for Medicare & Medicaid Services has proposed a new regulation implementing this policy that NAUH believes will detract from the ability of private safety-net [...]
Federal Medicaid Per Capita Spending Limits?
As they have in the past, some members of Congress have suggested of late that Medicaid might benefit from being transformed into a program with limited spending per capita: that is, such an approach would limit the amount of money [...]
New ACO Model Targets Social Determinants of Health
The federal government is altering a previously announced accountable care organization model to help it target the social determinants of health of the patients it serves. The Accountable Health Communities model, launched by the Centers for Medicare & Medicaid Services [...]
NAUH Comments on Proposed Medicaid DSH Regulation
The National Association of Urban Hospitals has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments. In particular, NAUH opposes [...]
Risk Adjustment Needed for Joint Replacement Model, Study Says
Medicare’s Comprehensive Care for Joint Replacement bundled payment program will penalize hospitals that care for sicker patients unless it is risk-adjusted, according to a new study. The study, published in the journal Health Affairs, is based on an analysis of joint [...]
CMS Posts Tentative List of Essential Community Providers
The Centers for Medicare & Medicaid Services has posted on its web site a draft list of essential community providers for 2018. To qualify as essential community providers, organizations must serve predominantly low-income, medically underserved patients. Qualified health plans must contract [...]
Hospital Group Models Risk-Adjusted Medicare Readmissions
The Missouri Hospital Association has published data that demonstrates that risk-adjusting Medicare readmissions based on social determinants of health reduces the readmission rates of hospitals that care for large numbers of low-income patients. The data, modeling, and risk adjustment methodology, [...]
Amid Rising Improper Medicaid Payments, CMS Offers Help
With improper Medicaid payments nearly twice as high as they were just a few years ago, the Centers for Medicare & Medicaid Services is reaching out to state Medicaid programs with suggestions for how to reduce those improper payments. The [...]
