SNAPShots

SNAPShots

Are Readmission Penalties Bad Medicine for Medicare Patients?

As the federal government prepares to penalize hospitals with high readmission rates, new research suggests that appropriate readmissions may actually result in better care for the nation’s seniors.

According to new research, some hospitals that have high readmissions rates for the medical conditions that Medicare tracks – heart attacks, heart failure, and pneumonia – also have higher survival rates among patients with those conditions.

Such findings, while preliminary, call into question the manner in which Medicare intends to adjust future payments to hospitals based on their readmission rates in the value-based purchasing program it will introduce in October of this year.

This issue is of particular concern to Pennsylvania’s safety-net hospitals, which care for many low-income and dually eligible seniors who have had sporadic contact with the health care system throughout their lives and often present multiple medical challenges that require more than one hospitalization to address.

Read more about these new findings and their implications in this Kaiser Health News reportHospital.

 

2012-07-27T06:00:16+00:00July 27th, 2012|Uncategorized|Comments Off on Are Readmission Penalties Bad Medicine for Medicare Patients?

New Medicare Program Could Hurt PA’s Safety-Net Hospitals

A new federal initiative will use patient satisfaction to help determine Medicare payments to hospitals.

Under the new value-based purchasing program it will launch in October, Medicare will use the results of patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) as a factor in determining its payments to hospitals.

As reported in the Pittsburgh Post-Gazette, not everyone believes there is a tangible link between patient satisfaction and the quality of care a hospital provides – and not everyone believes the HCAHPS survey accurately measures either.

In addition, a recent article in the Archives of Internal Medicine reported that safety-net hospitals generally receive lower scores on the HCAHPS survey than other providers – a potentially major concern for Pennsylvania’s safety-net hospitals.

Read more about this controversial program in this Pittsburgh Post-Gazette reportDoctor listening to patient.

2012-07-24T06:00:56+00:00July 24th, 2012|Uncategorized|Comments Off on New Medicare Program Could Hurt PA’s Safety-Net Hospitals

DSH and the Affordable Care Act

The National Health Law Program has prepared a useful Q&A about how the Affordable Care Act and its Medicaid expansion will affect Medicare disproportionate share (Medicare DSH) and Medicaid disproportionate share (Medicaid DSH) payments, both of which are so important to Pennsylvania’s safety-net hospitals.

Download that summary here.

2012-07-19T06:00:21+00:00July 19th, 2012|Health care reform, Medicaid supplemental payments|Comments Off on DSH and the Affordable Care Act

Medical Assistance Primary Care Rates to Rise

Rates for primary care services covered by Pennsylvania’s Medical Assistance program will rise upon implementation next year of a new federal regulation recently published in draft form by the Centers for Medicare & Medicaid Services (CMS).
Under the proposed regulation, Pennsylvania must pay Medicare-level rates for Medicaid-covered primary care services in 2013 and 2014.  Medicare rates are higher for such services than Pennsylvania’s Medical Assistance rates, and under the proposed regulation the federal government, not the state, will pay for the difference between Medicare and Medicaid rates.
This new policy was mandated by the Affordable Care Act.  In addition to raising fee-for-service rates, Pennsylvania will be expected to revise agreements with its contracted HealthChoices plans to ensure that they, too, pay the better rates.
The higher rates should be especially beneficial for Pennsylvania safety-net hospitals because of the large numbers of Medicaid patients they serve.
Proponents of the higher rates believe they will improve access to primary care services for the Medicaid population and possibly reduce future Medicaid costs by helping recipients get more timely care and thereby avoid more serious illnesses.
Learn more about the proposed Medicaid rate increase in a Commonwealth Fund blog entry and find the entire proposed regulation hereHealth Benefits Claim Form.  Interested parties have until June 11 to submit written comments to CMS.

2012-05-30T06:00:45+00:00May 30th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Medical Assistance Primary Care Rates to Rise

Readmissions Report

The Pennsylvania Health Care Cost Containment Council (PHC4) has issued a new report on hospital readmissions.
Health care reform efforts at both the state and federal levels have targeted avoidable hospital readmissions as major causes of rising health care costs.   In issuing the report, PHC4 notes that not all readmissions are preventable.
Preventing readmissions is a particular challenge for Pennsylvania safety-net hospitals because of the difficulties many low-income patients have complying with their post-discharge medical instructions.
Read more about the report and download Hospital Readmissions in Pennsylvania 2010 hereHospital, on the PHC4 web site.

2012-05-02T06:00:37+00:00May 2nd, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off on Readmissions Report
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