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 [...]
There’s More to Quality Than Readmissions, Study Suggests
Hospitals with high readmissions rates may also have lower mortality rates for some conditions, according to a new study. The study, published in the Journal of Hospital Medicine, found that patients suffering from heart failure, stroke, and chronic obstructive pulmonary disease [...]
NAUH Comments on Proposed Medicare Site-Neutral Outpatient Payment Changes
The National Association of Urban Hospitals has submitted extensive comments to the Centers for Medicare & Medicaid Services on the agency’s proposal to implement site-neutral payment policies for Medicare-covered outpatient services. In its comments, NAUH raises objections to: how the [...]
Journal Looks at Health Disparities
The journal Health Affairs looks at health disparities and social determinants of health in its August 2016 issue. The article “Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health” looks at interventions that focus on social [...]
