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CMS Seeks to Slow “Meaningful Use” Timetable

The federal government has proposed extending the deadlines for health care providers to demonstrate “meaningful use” of health information technology and receive supplemental Medicare and Medicaid payments to help pay for the acquisition and implementation of that technology.
As proposed by the Centers for Medicare & Medicaid Services (CMS), Stage 2 deadlines for demonstrating use of electronic health records, originally set for 2014, would be pushed back to 2016 and Stage 3 deadlines, currently in 2016, would begin in 2017 for qualified providers.
Funding for the supplemental payments comes through the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act.
Learn more about the program and why CMS is proposing a delay in this explanation on the CMS web site.

PA Safety Net Admin2013-12-12T06:00:23+00:00December 12th, 2013|Uncategorized|Comments Off

Docs Dropping Medicare in Growing Numbers

More than 9500 doctors stopped accepting Medicare in 2012 – nearly three times as many who dropped out of the program just three years earlier.
In addition, the proportion of family doctors who accepted new Medicare patients that year fell from 83 percent in 2010 to 81 percent.
While most doctors who leave Medicare cite what they consider to be its inadequate payment rates, some do not want to adopt electronic health records and others feel that they can fare better financially without the additional staff needed to process Medicare claims.
While some Medicare patients choose to pay out of their own pocket rather than switch doctors, that is seldom an option for most of the low-income patients served by Pennsylvania’s safety-net hospitals.
Read more about the challenges Medicare faces in retaining enough doctors to serve the nation’s aging population and why more doctors are dropping out of the program in this Wall Street Journal article .

PA Safety Net Admin2013-07-31T06:00:37+00:00July 31st, 2013|Uncategorized|Comments Off

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress.
The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report.
First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid.
And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than the program’s limit to retain their Medicaid eligibility for several additional months.
The MACPAC report also includes analyses of several issues involving services for dually eligible (Medicare and Medicaid) individuals.
Because Pennsylvania’s safety-net hospitals serve so many Medicaid, CHIP, and dually eligible patients, MACPAC’s recommendations and analyses can be especially important to them.
Find the MACPAC March 2013 report here .

PA Safety Net Admin2013-03-25T06:00:01+00:00March 25th, 2013|Uncategorized|Comments Off

Bill Would Create New Residency Positions

A new bill before Congress would create 15,000 new Medicare-sponsored medical residency spots – the first such new positions in 15 years.
Half of those slots would be for physicians training for careers in primary care.
The bill, which has bipartisan sponsorship, would cost between $9 billion and $10 billion over the next 10 years.
Medical residents play a major role in caring for low-income and uninsured patients in many Pennsylvania safety-net hospitals.
Read more about the possibility of new medical residency slots in this article from The Hill.

PA Safety Net Admin2013-03-18T06:00:44+00:00March 18th, 2013|Uncategorized|Comments Off

Sequestration Could Hit Southeastern PA Hospitals Hard

Hospitals in southeastern Pennsylvania could lose $50 million in patient revenue a year if the scheduled sequestration of federal spending takes effect on March 1.
At that time, all Medicare payments to hospitals would be cut two percent.
In addition, hospitals in that region could lose another $41 million from a comparable cut in National Institutes of Health (NIH) spending.
Safety-net hospitals located in southeastern Pennsylvania would suffer a significant proportion of both of these cuts. Members of the Safety-Net Association of Pennsylvania (SNAP) located in this region include the Albert Einstein Medical Center, Hahnemann University Hospital, the Hospital of the University of Pennsylvania, Pennsylvania Hospital, Penn Presbyterian Medical Center, St. Christopher’s Hospital for Children, The Children’s Hospital of Philadelphia, and Thomas Jefferson University Hospital.
To learn more about how sequestration could affect one group of Pennsylvania safety-net hospitals, see this Philadelphia Inquirer article .

PA Safety Net Admin2013-02-27T06:00:15+00:00February 27th, 2013|Safety-Net Association of Pennsylvania|Comments Off

Medicare Reveals First Results of Quality Program

Slightly more than half of all U.S. hospitals will receive enhanced payments from Medicare and slightly fewer than half will see their payments reduced slightly as a result of the first reporting period for Medicare’s new value-based purchasing program.
The largest bonus will be awarded to Treasure Valley Hospital, in Utah. Each of its Medicare payments will rise 0.83 percent. The largest penalty will be assessed to Auburn Community Hospital, in Syracuse, which will see its Medicare payments reduced 0.9 percent. Two-thirds of all hospitals will see their payments rise or fall less than 0.25 percent.
Medicare’s value-based purchasing program, created by the Affordable Care Act, seeks to enhance provider accountability for the care they deliver. Seventy percent of a hospital’s score is based on its performance according to 12 basic standards of care and the rest of the score is based on the results of patient satisfaction surveys.
The program will be expanded in the coming years to encompass more standards of care. A companion program, based on Medicare readmissions within 30 days of patient discharge, is already under way and rewarding top performance and penalizing underperforming hospitals.
According to the figures released, 51 percent of Pennsylvania hospitals will receive bonuses through the value-based purchasing program and 49 percent will be penalized. Between the two programs – the value-based purchasing program and the readmissions reduction program – 20 percent of Pennsylvania hospitals will see a net increase in payments and the remaining 80 percent either broke even or will see their payments reduced.
Read more about the quality program in this Kaiser Health News report , which also offers links to lists of the results for every hospital in the country for both the Medicare value-based purchasing and readmissions reduction programs.

PA Safety Net Admin2012-12-31T06:00:30+00:00December 31st, 2012|Uncategorized|Comments Off

Post-Election Diagnosis for Health Care

While President Obama’s re-election probably spells the end of talk of repealing the Affordable Care Act, many questions remain about how – and how completely – the health care reform law passed in 2010 will be implemented.
In the days following the election, observers are asking these and other questions.
In the article “Federal Deficit Talks Could Impact Obama’s Moves on Health Law,” Kaiser Health News speculates about the future of some of the more controversial and expensive aspects of the Affordable Care Act, including creation of the Independent Payment Advisory Board; the extensive insurance subsidies for which many Americans will be eligible; the future of the medical device tax; and the law’s provisions that limit the degree to which insurers can charge higher rates for older people.
The Stateline web site looks at the decisions ahead for state governments in the article “Obama Win Means Big Health Care Decisions for States.” Many governors still have not declared whether their state will expand their Medicaid programs – a move required by the Affordable Care Act but made optional by the Supreme Court in a June 2012 decision.
The first issue that will be addressed, though, is state decisions on whether to create their own health insurance exchanges, a key part of the reform law, or let the federal government create those exchanges for them. States are required to inform the federal government of their intentions by November 16, although it now appears they will be given more time. Pennsylvania is among the states that have not yet declared their intentions.
Meanwhile, looming over the health care industry is the prospect of sequestration, part of last year’s deficit reduction compromise, that leaves Medicaid untouched but will require a cut of two percent in all Medicare payments beginning on January 1 unless Congress acts to prevent these cuts. Read more about this in an article from The Hill titled “Sequester Would Cut $11 Billion from Medicare.”
These and other issues are of particular importance to Pennsylvania’s safety-net hospitals because of the especially large numbers of low-income and publicly insured patients they serve.

PA Safety Net Admin2012-11-09T10:42:28+00:00November 9th, 2012|Health care reform|Comments Off

New Medicare Wrinkle May Hurt Safety-Net Hospitals

A new Medicare program that bases payments to hospitals in part on patient satisfaction with those hospitals could be especially harmful to the nation’s safety-net hospitals.
The Medicare value-based purchasing program, which took effect on October 1, will withhold one percent of all hospitals’ Medicare payments and then redistribute that money based on hospitals’ compliance with selected standards-of-care requirements and on the results of surveys of hospitalized Medicare patients. The withheld one percent will then be redistributed to hospitals that perform well based on these criteria. Beginning in 2017, two percent of hospitals’ Medicare payments will be withheld and eventually redistributed in this manner.
Learn more about the Medicare value-based purchasing program and how hospitals are preparing for the survey component of its payment adjustments in this Wall Street Journal article .

PA Safety Net Admin2012-10-16T06:00:55+00:00October 16th, 2012|Health care reform|Comments Off

Readmissions and Poverty

At a time when Medicare and many state Medicaid programs are attempting to penalize hospitals when patients are readmitted shortly after they were discharged, researchers have found that some of those readmissions are linked to factors beyond hospitals’ control.
According to research presented recently at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions 2012, differences in regional readmission rates are more closely tied to socioeconomic factors and access to care than they are to hospitals’ performance.
Researchers found that nine percent of regional variation in hospital readmission rates can be tied to patients’ poverty. Access to care, based on the availability of doctors and hospital beds, can be tied to 17 percent of regional variation in readmission rates.
The Safety-Net Association of Pennsylvania (SNAP) has long maintained that the low-income patients safety-net hospitals serve in especially large numbers come to them fundamentally sicker than typical hospital patients and require more resources and more effort to treat. This research appears to support this contention.
Read more about the research in this news release from the American Hospital Association.

PA Safety Net Admin2012-05-14T09:25:32+00:00May 14th, 2012|Safety-Net Association of Pennsylvania|Comments Off

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