Increase Use of Value-Based Purchasing, HHS Told
A study performed for the U.S. Department of Health and Human Services calls for greater use of value-based purchasing in federal health care reimbursement policy. The study, performed by the RAND Corporation, recommends developing a national value-based purchasing strategy; developing [...]
President Presents Proposed FY 2015 Budget
Yesterday the Obama administration unveiled its proposed FY 2015 federal budget. The spending plan addresses a number of key matters for private safety-net hospitals, including proposed cuts in Medicare bad debt reimbursement, graduate medical education payments, market basket updates for [...]
CMS Offers Additional Guidance on “Two-Midnight Rule”
The Centers for Medicare & Medicaid Services (CMS) has issued additional information about its plans for implementing the so-called Medicare two-midnight rule. The rule, which officially took effect last August, has been the subject of controversy, questions, and clarifications ever [...]
States Face Challenges in Outside-the-Box Medicaid Expansion
For most states expanding their Medicaid program in response to the opportunity afforded by the Affordable Care Act, expansion has been fairly straightforward: they simply let more people into their existing Medicaid programs. But several states – Arkansas, Iowa, and [...]
Enthusiasm Waning for Permanent Medicare Doc Fix
While most health care interests and members of Congress want to see a permanent end to the annual Medicare “doc fix” problem, it appears increasingly likely that the next “fix” will be yet another short-term patch. The obstacle? How to [...]
New Approaches to Serving Dual Eligibles Set to Launch
Provisions in the Affordable Care Act that encourage states to take new approaches to serving their dually eligible residents – low-income seniors eligible for both Medicare and Medicaid – will soon translate into new state programs. Massachusetts has already launched [...]
Some Hospitals Stand to Lose Medicaid Expansion, DSH Money
When the Supreme Court made Medicaid expansion optional rather than mandatory for states, its decision affected the delicate balance of one aspect of the Affordable Care Act. Hospitals that serve large numbers of low-income and uninsured patients receive special supplemental [...]
CMS Seeks to Shape Provider Networks
Insurers offering qualified health plans in the federally facilitated marketplace will soon be required to meet federal standards for the adequacy and breadth of their provider networks. According to a letter issued by the Centers for Medicare & Medicaid Services [...]
Observation Status, the “Two-Midnight Rule,” and Continuing Controversy
Amid continuing complaints from hospitals, the Centers for Medicare & Medicaid Services (CMS) has delayed implementation of its so-called Medicare two-midnight rule for another six months. Implementation of the rule, originally scheduled for October 1, 2013 and delayed for six [...]
ACOs Show Encouraging Signs
Provider groups that just completed their first year in Medicare’s ACO programs are showing encouraging signs of producing health care savings. In all, the Centers for Medicare & Medicaid Services (CMS) reports $380 million in savings for first-year participants. Nearly [...]
