Congressional Task Force Considers Medicaid Reforms
A House Energy and Commerce Committee group is looking at potential Medicaid reforms for 2017. The task force, consisting entirely of Republican members, was created late last year to “… strengthen and sustain the critical program for the nation’s most [...]
Quality Program Sometimes Rewarding Low Quality
A 2015 change in Medicare’s value-based purchasing program has resulted in some hospitals with low quality scores receiving bonus payments. The 2015 change added a low-cost measure to the program, and as a result, some hospitals that performed especially well [...]
Affordability a Challenge for Many Newly Insured
Many Americans who have obtained private health insurance through the Affordable Care Act continue to have problems affording health care. According to a Kaiser Family Foundation report based on focus groups six states, low-income individuals with new private insurance report [...]
Background Information on Payment Methodologies and Benefit Design
The Urban Institute has issued two new papers with background information on health care payment methodologies and the design of health care benefits packages. The first paper, Payment Methods: How They Work, describes nine payment methodologies: fee schedules primary care capitation [...]
Medicare Proposes New Way to Pay Docs
Clinicians would be paid based more on the quality of care they provide than on the quantity of services they deliver under a new Medicare quality reporting and payment proposal released last week by the Centers for Medicare & Medicaid [...]
Data-Sharing Could Help Address “High-Fliers”
A new study suggests that hospitals might better serve frequent emergency room patients if they share data with one another. According to a new report in the journal JAMA Internal Medicine, nearly 70 percent of “high-fliers” – patients known to make [...]
CMS Unveils New Medicaid Managed Care Regulation
For the first time in more than 20 years, the federal government is introducing major changes in how it regulates Medicaid managed care. The Centers for Medicare & Medicaid Services describes the 1425-page rule as aligning Medicaid managed care with [...]
Do Medicare Patient Satisfaction Surveys Foster Opioid Abuse?
A coalition of physicians and medical providers has questioned whether Medicare’s patient satisfaction surveys indirectly encourage physicians to prescribe opioids to help their patients with pain problems. The New York Times reports that coalition participants …filed a petition Wednesday with [...]
Could Housing Support Help Medicaid Behavioral Health Patients?
Amid indications that assisting with permanent supportive housing can be a cost-effective, evidence-based way of helping to address the behavioral health needs of some Medicaid recipients, housing and behavioral health groups are beginning to take a closer look at how [...]
Readmissions Reduction Target Too High?
Medicare’s goal of reducing hospital readmissions 20 percent – a key aspect of its hospital readmissions reduction program - may be too ambitious, researchers have concluded after evaluating the results of a special Connecticut effort to reduce readmissions. In that [...]
