Access to Primary Care: So Far, So Good
The increase in the number of insured Americans as a result of Affordable Care Act reforms is not yet causing major problems with access to primary care services. While access problems have been reported in a few states – most [...]
Study Points to Risk of DSH Cuts
A new study suggests that future cuts in Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments could pose problems for hospitals that serve large numbers of uninsured patients. According to a new report in the journal Health Affairs, Such [...]
Proposed Medicare Inpatient Regulation Released
How will Medicare pay hospitals for inpatient services in FY 2015? The answer to that question begins with a regulation: the Medicare inpatient prospective payment system (IPPS) regulation for FY 2015. The Centers for Medicare & Medicaid Services (CMS) has [...]
Report Questions Fairness of Medicare Quality and Incentive Programs
A draft technical report by the National Quality Forum has called into question the fairness of Affordable Care Act Medicare programs that seek to provide financial incentives to hospitals that meet selected quality care standards and penalize those that fail [...]
OIG Recommends Site-Neutral Payments for Some Medicare Outpatient Surgery
The Centers for Medicare & Medicaid Services’ (CMS) Office of the Inspector General (OIG) has recommended that Medicare introduce site-neutral payments for low-risk and no-risk surgical procedures that could be performed in ambulatory surgical centers instead of hospital outpatient facilities. [...]
Medicare Risk Adjustment Methodology Questioned
Medicare should perform risk adjustment of payments to hospitals and insurers based on socioeconomic considerations or the overall health of populations rather than on the medical conditions of patients, according to a new study. Analysts at the Dartmouth Atlas Project [...]
Community Factors Influence Readmissions, Study Says
A new study reports that a variety of factors, including several linked to socio-economic status, account for 58 percent of the variation in the rate of Medicare hospital readmissions at the county level. Among those factors are low employment, living [...]
Medicaid Growth Doesn’t Mean Increased ER Use
A new study has found that increased enrollment in Medicaid does not necessarily result in increased use of hospital emergency rooms. Nor does it necessarily contribute to difficulty obtaining care. According to a study of ten states that eased their [...]
Web Site Flaw Keeps Medicaid, CHIP Applicants in Limbo
More than 400,000 people thought to be eligible for Medicaid and CHIP appear to have their eligibility determinations caught in the healthcare.gov web site. Through a flaw in the federal health care web site, eligibility notifications for these applicants have [...]
Will “Private Option” Mean Reduced Medicaid Benefits?
While many states have chosen to take advantage of the Affordable Care Act’s expansion of Medicaid simply by expanding their existing Medicaid programs, a number of states are pursuing a different approach: crafting programs that enable the newly eligible to [...]
