New Report Highlights Benefits of 340B Program
A new report describes how the federal government’s 340B Drug Pricing Program works, how it serves low-income participants, what might happen if the program were curtailed, and why the program remains as important as ever despite the declining number of [...]
Bill Proposes Modifying Ban on Higher Medicare Outpatient Payments
A new bill introduced in the House Ways and Means Committee would limit a recent prohibition on establishing new off-campus hospital outpatient facilities that can receive hospital-based Medicare outpatient payments. Under the Bipartisan Budget Act of 2015, new off-campus, hospital-based [...]
Bill Proposes Risk-Adjusting Medicare Readmissions Program
A new bill introduced in the House Ways and Means Committee would apply risk adjustment for socio-economic factors to Medicare’s hospital readmissions reduction program. According to a committee summary of the bill, The Helping Hospitals Improve Patient Care Act of [...]
Socio-Economic Factors Leading Cause in Pediatric Asthma Readmissions
African-American children suffering from asthma are readmitted to hospitals more often than other children primarily because of socio-economic factors, a new study published in JAMA Pediatrics has concluded. In a study conducted in Cincinnati, according to the report, “Socioeconomic hardship [...]
Covered by Medicare But Underinsured
Nearly a quarter of the country’s 50 million Medicare beneficiaries are underinsured and ill-equipped financially to handle the program’s cost-sharing responsibilities. Or so concludes a new report from the Commonwealth Fund. According to the report, Medicare’s cost-sharing requirements – premiums, [...]
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 [...]
