Archive for October, 2014


More Medicaid Expansion Coming?

Now that Arkansas, Pennsylvania, and Iowa have gained federal approval of Medicaid expansion proposals that call for more use of private insurers than states that simply expanded their existing Medicaid programs, it looks as if other states may follow a similar path.

New Hampshire and Indiana are already pursuing federal approval of customized approaches to Medicaid expansion.  Now, it appears that Tennessee, Utah, and Wyoming may follow suit after the November elections, when the political implications of Medicaid expansion will not be as great for Republican governors.

For a closer look at how states have tailored their own Medicaid expansion programs under the Affordable Care Act, how those plans are working, and how the federal government is treating such proposals, see this Stateline report.…

New Client

DeBrunner & Associates is pleased to welcome its newest client:  Brookside Homes of America.  Brookside takes a unique approach to meeting the community housing needs of nursing home-eligible Pennsylvanians.…

Innovation Center Introduces “Transforming Clinical Practices” Initiative

The federal Center for Medicare and Medicaid Innovation has launched a new, $840 million program designed to help clinicians achieve large-scale health transformation.

According to the agency’s news release, its “Transforming Clinical Practices” initiative

…will fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes, and coordinated health care systems. These applicants could include group practices, health care systems, medical provider associations and others. This effort will help clinicians develop strategies to share, adapt and further improve the quality of care they provide, while holding down costs.

The Center for Medicare and Medicaid Innovation was created as part of the Affordable Care Act and allocated $10 billion to spend on innovations in the delivery and financing of health care.  It expects to spend $840 million on this program over the next four years in increments of $2-50 million on “practice transformation networks” and “support and alignment networks.”  Hospitals, health systems, and large group practices are eligible to participate.

Letters of intent must be submitted by November 20 and the deadline for applications is January 6.

For further information about the …

Medicaid Directors Weigh in On Managed Care Regulation

The nation’s state Medicaid directors have offered their perspectives to the federal government on how to modernize and regulate state Medicaid managed care programs.

In a paper entitled “Medicaid Managed Care Modernization:  Advancing Quality Improvement,” the National Association of Medicaid Directors urges the Centers for Medicare Services (CMS) to work with the states to develop quality reporting measures that are both useful and not overly burdensome.

The association also asks CMS to leave decisions about accrediting requirements for state Medicaid managed care programs in state hands and not to establish a national quality rating system for Medicaid managed care plans.

Learn more about Medicaid directors’ recommendations for improving and regulating state Medicaid managed care programs in this National Association of Medicaid Directors correspondence with the Center for Medicaid and CHIP Services.…

Quality Does Not Suffer in Hospital Non-Profit to For-Profit Conversions

Hospitals that convert from non-profit to for-profit do not experience reduced quality or worse outcomes for their patients.

This is the chief finding of a new study published in the Journal of the American Medical Association.

According to “Association Between Hospital Conversions to For-Profit Status and Clinical and Economic Outcomes,” such conversions result in improved financial performance that does not come at the expense of quality of care, nor do such hospitals reduce the proportion of low-income and minority patients they serve.

Most of the converting hospitals are small or medium in size, located in the south or an urban or suburban area, and were not teaching hospitals.

For a more detailed look at the study, see this U.S. News & World Report article.  To examine the study itself, find it here, on the web site of the Journal of the American Medical Association.…