Archive for March, 2018


MedPAC Issues 2018 Report to Congress

The Medicare Payment Advisory Commission has issued its 2018 report and recommendations to Congress.

The report includes MedPAC’s recommendations for next year’s Medicare fee-for-service payments; a review of the Medicare Advantage and Medicare Part D programs, with recommendations; and a report telehealth required by the 21st Century Cures Act.

For Medicare fee-for-service rates, MedPAC proposes:

  • the inpatient and outpatient rate increases, physician and other health professional rate increases, and outpatient dialysis increase included under current law
  • no increase for ambulatory surgical centers, long-term-care hospitals, and hospice providers
  • no rate increase for skilled nursing facilities
  • a five percent reduction of payments for home health providers and the introduction of a two-year rebasing of home health rates beginning in 2020
  • a five percent reduction of inpatient rehabilitation facility payments

In addition, MedPAC recommends that Medicare base future payments to post-acute providers on a blend of “each sector’s setting-specific relative weights and the unified post-acute care prospective payments system’s relative weights.”

MedPAC also recommends that Medicare abandon its merit-based incentive payment system (MIPS) in favor of an alternative approach for achieving “the shared goal of high-quality clinician care for beneficiaries in traditional Medicare.”

MedPAC is a non-partisan legislative branch agency that advises …

MACPAC Issues Annual Report, Recommendations to Congress

The Medicaid and CHIP Payment and Access Commission has published its annual report and recommendations to Congress.

MACPAC’s report addresses three primary areas:  Medicaid managed care, telehealth, and Medicaid disproportionate share payments (Medicaid DSH).

With 80 percent of Medicaid beneficiaries now enrolled in managed care plans, MACPAC offers three major recommendations for improving Medicaid managed care efforts:

  • permit states to require all of their Medicaid beneficiaries to enroll in a managed care plan
  • extend Medicaid managed care section 1915(b) waivers from two to five years
  • permit states to obtain waivers to waive freedom of choice and selective contracting restrictions

MACPAC notes the growing use of telehealth by state Medicaid programs and encourages states to continue this expansion while learning more from the efforts of one another to use telehealth effectively.

Finally, MACPAC notes that it

…continues to find little meaningful relationship across the country between DSH allotments and number of uninsured individuals, hospitals’ uncompensated care costs, and the number of hospitals providing essential community services that have high levels of uncompensated care. Total hospital charity care and bad debt continue to fall, especially in states that expanded Medicaid coverage, but Medicaid shortfall showed an uptick as a result of increased

CMS Reports on Quality Measures Performance

The Centers for Medicare & Medicaid Services has published a new report detailing the progress of health care providers in meeting Medicare quality standards and improving their performance under those standards.

The report, required every three years, focuses on 17 key indicators of quality in the delivery of health care as defined by 247 individual quality measures.

The analysis found that:

  • 670,000 patients improved their control of their blood pressure
  • 510,000 fewer patients have poor control of their diabetes
  • 12,000 fewer people died following hospitalization for a heart attack
  • there were 70,000 fewer unplanned hospital readmissions
  • nursing home residents suffered 840,000 fewer pressure ulcers

In addition, the study reported cost savings associated with better compliance with quality standards, including:

  • $4.2 billion to $26.9 billion saved because of better compliance with medication instructions
  • $2.8 billion to $20 billion saved through fewer treatments for pressure ulcers
  • $6.5 billion to $10.4 billion saved because patients manage their diabetes more effectively

The study also looks hospital and nursing home performance variations based on race and ethnicity, income, sex, urbanicity, region, and age for many quality measures.

Learn more about Medicare’s quality measures and how hospitals and nursing homes are performing under these measures in …

Primary Care Spending Declines Amid Health Care Cost Rise

At a time when health care costs continue to rise, spending for primary care is declining.

This is the conclusion of an analysis of Health Care Cost Institute Data published on the Health Affairs Blog.

According to the analysis, spending on primary health care declined six percent between 2012 and 2016 – more than twice the rate of the decline in spending for any other type of care.

These results concern analysts because research shows that investment in primary care services generally improves population health at less cost.

The decline is in utilization, not price, and while the reasons for decreased utilization are not certain, among the factors are thought to be high-deductible insurance plans, increased cost-sharing, greater use of urgent care, and a general preference for specialist services.

Learn more about the data, the trend, and its implications in the Health Affairs Blog report “Disinvesting in Primary Care,” which can be found here.…

New Report Details Key Health Care Provisions in February Budget Bill

The Congressional Research Service has published a new report describing the health care-related provisions in the Bipartisan Budget Act of 2018 that Congress passed last month to fund the federal government.

A major part of that law was the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act, and the new report includes descriptions of the Medicare, Medicaid, CHIP, public health, and other health care aspects of the law.

Go here to find the Congressional Research Service report Bipartisan Budget Act of 2018 (P.L. 115-123): Brief Summary of Division E—The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act.