Archive for May, 2013


Medicare Readmissions Down

For the first time in years, the proportion of Medicare readmissions fell significantly in 2012.

Nation-wide, Medicare hospital readmissions within 30 days of discharge fell from 19 percent, where they had been from 2007 through 2011, to 18.4 percent in 2012, according to a new analysis by the Centers for Medicare & Medicaid Services (CMS).  This is considered a statistically significant decline.

This information comes from a new report, “Medicare Readmissions Rates Showed Meaningful Decline in 2012,” published by CMS’s Office of Information Products & Data Analytics.

While the report does not speculate on the cause of the decline, attention is expected to focus on actions hospitals have taken to prevent readmissions in response to implementation of Medicare’s hospital readmissions reduction program, which imposes financial penalties on hospitals with what CMS deems to be “excessive” readmissions.

Read a summary of the report and find a direct link to the document itself here, on CMS’s web site.…

Health Problems, Not Geography, Dictate Medicare Costs According to New Study

Medicare spends more where patients are sicker and not based on where those sick patients live, according to a new study.

This is the case because people in some parts of the country are sicker than people in other parts, necessitating greater expenditures by Medicare.

The new study, published in the journal Medicare Care Research and Review, contradicts previous work by the Dartmouth Institute for Health Policy and Clinical Practice, which has long held that the geographic variation in Medicare spending is based on how medicine is practiced in different parts of the country and not on the clinical challenges posed by Medicare beneficiaries.

Dartmouth researchers have rejected the new study’s findings.

Read more about this latest attempt to determine why Medicare spends more in some parts of the country than in others in this Kaiser Health News report.  Find the new study here, on the Medicare Care Research and Review web site.…

Medicaid Pay Raise Isn’t Reaching Docs

The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians.

Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients.

The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions.  Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014.

Five months into 2013, however, only Maryland, Massachusetts, Nevada, and Michigan are making the higher payments.

Learn more about the thinking behind the pay raise and why most states still are not paying it in this Washington Post article.…

Medicare Readmissions Penalties Show Signs of Hitting Safety-Net Hospitals Hardest

Penalties assessed by Medicare’s hospital readmissions reduction program appear to be falling especially hard on hospitals that serve large numbers of low-income patients.

This is the conclusion reached by researchers analyzing the program’s impact on California hospitals.  There, they found that most of the state’s hospitals that paid the stiffest penalties for Medicare readmissions are located in areas with large populations of low-income patients.

The article “Medicare penalizes hospitals with high readmissions,” published by the Center for Health Reporting, notes that

Several of the hospitals paying big penalties this year are scattered up and down the sprawling Central Valley, from Tulare to Oroville, a region known for chronic health problems such as obesity and diabetes.

Others serve under-privileged Los Angeles area neighborhoods that also have health challenges and lack the medical networks of wealthier communities.

Learn more about how Medicare’s goals for reducing preventable hospital readmissions are clashing with real-world health care challenges here, on the Center for Health Reporting’s web site.…

PA Hospital Performance Shows Mixed Results

Pennsylvania hospitals experienced lower margins and higher uncompensated care costs in 2012, according to a new report released by the Pennsylvania Health Care Cost Containment Council (PHC4).

Acute-care hospital total margins fell 1.22 percentage points in 2012, from 7.04 percent to 5.82 percent, while uncompensated care passed the billion dollar mark for the first time, with a 6.4 percent increase in such costs driving the total to $1.04 billion.  Operating income and operating margins rose while net income fell.

Learn more about Pennsylvania acute-care hospitals’ 2012 financial performance and find a link to the report Financial Analysis 2012:  Volume One:  General Acute Care Hospitals here, on the web site of the Pennsylvania Health Care Cost Containment Council.…