Archive for July, 2012


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 hospital readmissions reduction program it will introduce in October of this year.

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

Adequacy of Medicaid Payments Varies Widely Nation-wide

Medicaid payments for primary care services vary significantly in their adequacy in comparison to the payments providers receive from private insurers.

According to a Washington Post blog based on a Forbes magazine report, state Medicaid payments for primary care range from 29 percent of private insurer payments (Rhode Island) to 112 percent of private insurer payments (Alaska).

The figures also suggest that the states with the broadest Medicaid programs generally pay the least and those that cover more people pay better.

Find the article, and an excellent 50-state map presenting payment comparability, in this Washington Post blog.…

Downgrades Outpace Upgrades in Latest Moody’s Report

Moody’s downgraded the credit ratings of more non-profit hospitals than it upgraded during the first quarter of 2012.

The ratings company cited the still-slow economy and state and budget pressures as the primary reasons for its downgrades.

Read more about Moody’s most recent ratings of non-profit hospitals in this Reuters report.…

Medicaid Directors Weigh in on Payment Reform

The National Association of Medicaid Directors has issued a policy paper on Medicaid payment and delivery system reform and innovation.

In the policy brief, the association addresses fives types of reforms that states either are in the process of developing or are considering:  targeted payment adjustment policies, managed fee-for-service, bundled payments, managed care initiatives, and health homes.

The paper also addresses the considerations states need to weigh before embarking on such reforms.

Download this paper here, from the web site of the National Association of Medicaid Directors.…

New Program to Link Patient Satisfaction, Medicare Payments

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.

Read more about this controversial program in this Pittsburgh Post-Gazette report.…