Archive for April, 2015


Mixed Results for Doc Quality Reporting Program

Nearly a half-million providers will see their Medicare payments docked this year because they failed to submit to Medicare data required by its Physician Quality Reporting System in 2013.

On the other hand, nearly 650,000 will receive a 0.5 percent raise because they did comply.

Lack of compliance may not be the issue it seems on the surface: of those who failed to submit the required quality data and face penalties of up to 1.5 percent of Medicare payments, 70 percent see fewer than 100 Medicare patients a year.

Medicare’s Physician Quality Reporting System was introduced in 2007.   In 2013, providers were required to report on as many as 100 quality measures; this year, they are only being asked to provide data on nine such measures.

To learn more about provider compliance with Medicare’s Physician Quality Reporting System, see this Wall Street Journal article.…

Inpatient Rehab Facilities to Get Rate Increase

Medicare would increase inpatient rehabilitation facility rates 1.7 percent for FY 2016 under a new regulation it proposed last week.

To receive the full increase, facilities would have to submit quality data on a number of factors, including patients with pressure ulcers, incidence of falls, performance of functional status assessments, and others. Facilities that fail to report the requested data would receive no increase and instead would see their payments reduced.

For a closer look at how Medicare proposes paying inpatient rehabilitation facilities in FY 2016, see this fact sheet and the regulation itself.…

PA Completes First Phase of Medicaid Transition

Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program.

Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014. In the next few days they will receive written notification of the shift. All will receive the same Medicaid benefits: a basic adult benefit package.

Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by September 1.

For more information about the continued transition from Healthy Pennsylvania to HealthChoices, see this news release from the governor’s office.…

What is “Population Health”?

Among the three goals of health care reform is “improving population health.”

But what is “population health”?

Members of the faculty of the online Executive Master of Health Administration program at George Washington University decided to ask hospital CEOs that very question. The results of their survey will be published later this month but Fierce Healthcare offers a preview. Find that preview here.…

New Client

DeBrunner & Associates is pleased to welcome our newest client: Virginia Hospital Center, a 342-bed hospital located in Arlington, Virginia.