Archive for June, 2016


Introducing the “Micro-Hospital”

They’re not quite urgent care centers and they’re not quite hospitals. They’re “micro-hospitals,” and they are starting to sprout up in different parts of the country.

Micro-hospitals are small: generally 15,000 to 30,000 square feet. They typically have emergency rooms, examination rooms, operating rooms, and inpatient rooms for observation care and short stays. They offer lab and radiology services and are open 24 hours a day, seven days a week. They cost more than urgent centers and less than hospitals and some insurers are still trying to figure out how to pay them.

The state of Colorado licenses micro-hospitals as “community hospitals,” a term that usually has an entirely different connotation, and they are thought to be better suited for large urban and suburban metro areas. Often, they are introduced in areas where the demand for care is not sufficient to merit the development of a full-scale hospital but where they can feed patients to their health system owners.

Learn more about micro-hospitals in this Fierce Healthcare article and this report in the Denver Post.…

Telemedicine Finally Catching On

After years of talk about the promise of telemedicine, that promise is starting to transform into actual practice.

Across the country, doctors are communicating with patients by phone, email, and webcam, patients are transmitting information by monitors and smartphone apps, and doctors are consulting with other doctors – in some cases with lives on the line.

Meanwhile, some insurers are welcoming the opportunity to serve their patients through telehealth services while others are still resisting. Medicare has been slow to adopt, but a number of proposals in Congress to make telehealth services more accessible to Medicare patients enjoy bipartisan support.

Meanwhile, regulatory issues sometimes muddle the question of whether doctors licensed in one state can provide consulting services to patients or even other doctors in other states in which they are not licensed.

And at the same time, a number of institutions are gearing up to make telehealth services among their major offerings – and not only to patients but also to other institutions.

Learn more about how telehealth is beginning to make serious in-roads into the American health care system in this Wall Street Journal article.…

Medicare ACOs Showing Promise Among Clinically Vulnerable

A new study has found that Medicare patients with multiple acute or chronic medical conditions who are served by accountable care organizations cost less to serve and visit hospital emergency rooms less frequently.

Such patients also had fewer ambulatory care-sensitive hospital admissions and 30-day hospital readmissions.

The study, published in JAMA Internal Medicine, traced the reduction in costs to providers making less use of institutional settings when treating their clinically vulnerable patients.

To learn more about the study and its potential implications for both taxpayers and the 23 million Americans enrolled in more than 700 ACOs, go here to see a report from the Commonwealth Fund or go here to read the JAMA Internal Medicine study “Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries.”


CMS Proposes Changes in Terms of Medicare, Medicaid Provider Participation

The Centers for Medicare & Medicaid Services has proposed changes in the terms under which hospitals may participate in Medicare and Medicaid.

Among those changes, hospitals must:

  • establish an infection prevention and control program with qualified leaders
  • establish an antibiotic stewardship program with qualified leaders
  • establish policies prohibiting discrimination based on race, color, religion, national origin, general, sexual orientation, age, and disability
  • incorporate readmission and hospital-acquired conditions information into their Quality Assessment and Performance Improvement program
  • improve their medical record-keeping and provide for patient access to those records

Learn more what CMS has proposed and why it has proposed it in this CMS news release and this CMS fact sheet. CMS is accepting comments about the proposed changes until August 15. Find a link to the proposed rule itself here.…

MACPAC Submits Annual Report to Congress

The non-partisan agency that advises Congress on Medicaid and Children’s Health Insurance Program issues has submitted its annual report to Congress.

In that report, the Medicaid and CHIP Payment and Access Commission offers an overview of historical federal spending on Medicaid, noting that Medicaid spending per beneficiary is growing slower than health care spending covered by Medicare and private insurance.

The MACPAC report also examines different approaches to Medicaid financing, including block grants, capped allotments, per capita limits, and more, reviewing the impact changes in Medicaid financing could have on care, state financing, providers, and state decision-making authority.

In addition, MACPAC looks at the more than 100 different tools used at the state level to assess the functional capabilities of individuals who may be eligible for Medicaid-funded long-term services and supports.

For a closer look at what MACPAC had to say about these and other Medicaid- and CHIP-related issues, go here for a news release accompanying its annual report and a link to that report.…