Is Medicare “Pay for Performance” Doing the Job?
Three Medicare initiatives – its hospital readmissions reduction program, value-based purchasing program, and hospital-acquired condition program – were designed to improve the quality of care provided to beneficiaries while eventually reducing the cost of that care. But are they living [...]
Hospitals Stung By Readmissions Penalties
More than half of the nation’s hospitals are being penalized by Medicare for readmitting too patients. Together, they will loses $420 million in Medicare payments. The penalties are part of Medicare’s hospital readmissions reduction program, which penalizes hospitals for readmitting [...]
CMS: No New Home Health Agencies, Ambulance Services in Some Cities
The federal government is extending its current moratorium on new home health agencies serving Medicare beneficiaries in and around selected cities across the country. The affected areas include the Chicago, Dallas, Detroit, Fort Lauderdale, Houston, and Miami metropolitan areas. The [...]
CMS Proposes New Medicaid Substance Abuse Initiatives
The Centers for Medicare & Medicaid Services (CMS) has announced a new initiative designed to improve how states identify and serve Medicaid beneficiaries with substances use disorders (SUD). According to a recent notice sent by CMS to state Medicaid directors, [...]
CMS to Expedite Review of Some Medicaid Waiver Applications
The federal government will streamline the renewal process for state Medicaid waivers for demonstration programs that are established and achieving their goals and for which major changes are not being proposed. According to an informational bulletin issued by the Centers [...]
The Challenges Medicaid Faces
As it celebrates is fiftieth birthday, Medicaid now covers 70 million Americans at a cost of $500 billion a year. As the program continues to grow amid the expansion facilitated by the Affordable Care Act, Kaiser Health News has identified [...]
GAO Looks at Behavioral Health Options
Access to behavioral health services can be a challenge for low-income adults, so the U.S. Government Accountability Office (GAO) recently looked into those challenges. In a new report, the GAO examined how many low-income adults have behavioral health problems, where [...]
Graduate Medical Education: Boon or Bane for Hospitals’ Bottom Line?
Do hospitals make money on graduate medical education? Do they lose money subsidizing positions above and beyond the funding they receive for completing the training of the next generation of doctors? Are there other benefits hospitals reap from medical education [...]
Will Growing Medicaid Costs Swamp State Budgets?
Many states that expanded their Medicaid programs under the Affordable Care Act have experienced far greater increases in enrollment than projected and are now worried about their future ability to pay for the increased costs associated with that greater enrollment. [...]
South Carolina Hospitals Reduce Readmissions
A state-wide effort among South Carolina hospitals has reduced readmissions in that state. With most of the state’s hospitals participating, the Preventing Avoidable Readmissions Together program (PART) used multi-disciplinary rounds, post-discharge phone calls, teach-back, better discharge summaries, and timely follow-up [...]
