Archive for March, 2017


CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.”

How is that initiative working so far?  CMS recently released three reports that evaluate different aspects of the program.  Those reports are:

In addition to viewing the reports, go here to learn more about the Medicare-Medicaid Financial Alignment Initiative.


Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well:  replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants.

In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid.  Among the issues the brief addresses are:

  • why such a switch would matter to low-income seniors at all
  • how it might change federal funding of Medicaid for low-income seniors
  • how states might react in ways that would affect low-income seniors
  • how it might affect the providers who serve low-income seniors
  • how such an approach might vary from state to state

Learn more about a possible change in how the federal government pays for its share of the Medicaid program that will surely find its way into future health policy discussions and debates in the Kaiser Family Foundation issue brief “What Could

Non-Profit Illinois Hospitals Keep Tax Exemption – for Now

Non-profit Illinois hospitals will not have to start paying local property taxes.

At least not right away.

That decision comes from the Illinois Supreme Court, which did not address the question of whether hospitals merit exemption from the local property taxes that some Illinois communities seek to impose on them.  Instead, the Supreme Court concluded that the lower courts that ruled unconstitutional the law giving these hospitals their tax-exempt status lacked the jurisdiction to making such a ruling.

So the Illinois Supreme Court sent the case back to a circuit court to be reconsidered.

Learn more about the latest in attempts by local governments to pursue local tax revenue from non-profit hospitals in Illinois in this Chicago Tribune article.…

MACPAC Looks at Medicaid DSH

Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act.

So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues.

In its March 2017 report to Congress, MACPAC writes that

In both expansion and non-expansion states, deemed DSH hospitals, which are statutorily required to receive DSH payments because they serve a high share of Medicaid-enrolled and low-income patients, continue to report negative operating margins before DSH payments.

 Learn more about this evaluation, and other facets of the Medicaid DSH program, in this March 2017 report from MACPAC to Congress.  Find a summary of the report here.…

MedPAC Offers Provider Rate Recommendations for FY 2018

The Medicare Payment Advisory Commission has submitted its annual Medicare payment rate recommendations to Congress.

The recommendations, required by law, include:

  • rate increases as required by current law for hospital inpatient payments, hospital outpatient payments, physicians, other health professional services, and outpatient dialysis payments;
  • no updates for ambulatory surgical centers, skilled nursing facilities, long-term-care hospitals, and hospices; and
  • five percent rate reductions for home health agencies and inpatient rehabilitation facilities.

MedPAC continued its past practice of recommending reform of the manner in which Medicare pays for post-acute-care services, maintaining that the unified payment system it has proposed would save $30 billion over the next ten years.

The report also addresses the status of the Medicare Advantage program and the Medicare prescription drug program (Medicare Part D).

While MedPAC’s recommendations to Congress are not binding, they are highly influential and often form the basis for future public policy.

Learn more about MedPAC’s recommendations in this fact sheet with highlights of the agency’s March 2017 report to Congress or the report itself, which can be found here.