Archive for February, 2013


States Can Cut Medicaid Payments, Administration Says

States are free to reduce payments to providers to keep down their Medicaid costs, the Obama administration has told a court considering a challenge to a 10 percent cut in provider payments by California’s Medicaid program.

The administration weighed in on this subject in a legal brief submitted in a court case that will decide whether California can reduce its Medicaid payments to providers.

If California’s defense of its Medicaid payment cuts proves successful, it could provide a blueprint for other states to reduce payments at a time when most states are preparing for a significant expansion of their Medicaid rolls.  Many states are already concerned about the potential for rising Medicaid costs while others have opted out of Medicaid expansion or are still undecided, typically citing the potential for growing costs as the primary reason for their reluctance to expand their Medicaid programs as envisioned under the Affordable Care Act.

To learn more about the California case and its potential implications elsewhere, see this New York Times article.…

Medicaid Enrollment Down in PA

Enrollment in Pennsylvania’s Medical Assistance program declined by 55,000 people during the second half of 2012.

While it is not clear why enrollment dropped so significantly, one theory is that some people who lost their General Assistance cash assistance ­– a casualty of the state’s FY 2013 budget – did not reapply for Medical Assistance.  Others point to the inability of county assistance offices to process applications effectively.

Read more about the drop in Medicaid enrollment in Pennsylvania and its possible causes in this Philadelphia Inquirer article.…

Sequestration 101

Unless Congress and the President act in the next week, a process called “sequestration” – a product of the federal Budget Control Act of 2011 – will take effect in which significant cuts in federal spending will automatically and immediately take effect.

Significantly, from the perspective of hospitals, all Medicare payments to hospitals will be cut two percent.  (Medicaid is not affected by sequestration).

But what is sequestration and what are its implications for Medicare and those who depend on Medicare to pay for their patients’ services?

Learn more about sequestration here, on The Medicare Newsgroup web site, where you also will find several FAQs on different aspects of sequestration and its implications for Medicare.…

Communication and Medicare Readmissions

With all of the focus on hospital readmissions now that Medicare is penalizing hospitals for what it considers excessive readmissions of elderly patients, a new study suggests a simple reason for some of those readmissions:  poor communication.

The study – actually, more of a small, informal survey – found that readmissions can often be traced to physicians failing to give clear instructions and failing to ensure that patients have the ability to carry out those instructions and patients failing to comprehend instructions and to carry out even some of those they do understand.

Read more about the importance of communication in preventing hospital readmissions in this Forbes article.…

New Study Questions Link Between Readmissions and Outcomes

A new study suggests that hospitals with higher Medicare readmissions rates do not necessarily produce better results for their patients.

The study, “Relationship Between Hospital Readmissions and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia,” published in this month’s Journal of the American Medical Association, contradicts past research that supported the assertion of some in the medical community that hospitals that are more aggressive about readmitting patients have better long-term results in patient care.

The new study found no significant link between readmissions and mortality rates.  Some who have examined the new study, however, reject that conclusion.The study is published at a time when Medicare is being far more aggressive about penalizing hospitals financially for readmitting patients who have recently been discharged from the hospital.

Read more about the study and reaction to it in this Kaiser Health News article.  Find the study itself here, on the web site of the Journal of the American Medical Association.…