Medicare Unveils New ACO Program
The federal Center for Medicare and Medicaid Innovation is launching a new accountable care organization (ACO) model through which providers can join together to serve Medicare patients. The “Next Generation ACO” seeks to build on the experience, insight, and feedback [...]
Congress to Consider Adding Risk Adjustment to Medicare Readmissions Program
A new bill introduced in Congress this week would require Medicare to consider the social determinants of health of the patients individual hospitals serve as part of its hospital readmissions reduction program. The Establishing Beneficiary Equity in the Hospital Readmissions [...]
MedPAC Looks at Short-Stay Issues
The agency that advises Congress on Medicare payment issues is preparing to suggest changes in how Medicare approaches paying for short hospital stays. At last week’s meeting of the Medicare Payment Advisory Commission (MedPAC), commissioners received a staff presentation on [...]
MACPAC Looks at Medicaid, CHIP Issues
The Medicaid and CHIP Payment and Access Commission (MACPAC), the independent, non-partisan federal agency that advises Congress on the Medicaid and CHIP programs, met in Washington, D.C. recently to examine a number of issues under its purview. During two days [...]
HHS Inspector General Outlines 2015 Oversight Agenda
The U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) has presented its oversight priorities for 2015. Those priorities include the health insurance marketplace, including whether the right people are getting benefits and consumers’ personal information [...]
Insurance Expansion Won’t Hurt Access to Primary Care, Study Finds
Fears that significant increases in the numbers of Americans with health insurance as a result of Affordable Care Act policies would overwhelm the health care system and lead to access to care problems are unfounded, according to a new Commonwealth [...]
States Seek to Reduce ER Use Among Medicaid Patients
Even though the rate at which non-Medicaid recipients inappropriately use hospital emergency rooms exceeds the rate of inappropriate use among Medicaid patients, a number of states are launching efforts to reduce ER overuse among their Medicaid recipients. Medicaid patients currently [...]
Administration Blocks No-Hospitals Insurance Plans
Health insurance plans that do not include hospital benefits fail to meet employers’ obligations under the Affordable Care Act and will leave companies that provide such insurance vulnerable to fines of $3000 a year for every worker covered by such [...]
Proposal for Improving Medicare Physician Payments
Last year, Congress considered shifting Medicare’s payments to physicians from their fee-for-service foundation to a value-based purchasing approach as part of its attempt to address the Medicare sustainable growth rate (SGR) formula problem (the “Medicare doc fix”). With that problem [...]
MedPAC Looks at New Quality Measures
Amid Medicare’s effort to encourage hospitals to improve the quality of the care they deliver, the Medicare Payment Advisory Commission (MedPAC) looked at new possible quality measures to contribute to that effort during a recent meeting in Washington, D.C. Noting [...]
