Archive for April, 2017


Incentive Program Reduces Post-Acute-Care Costs

Participants in the Medicare Shared Savings Program are reducing Medicare expenditures for post-acute-care.

So reports a new study published in the journal JAMA Internal Medicine.

According to the study, the discharge of fewer patients into skilled nursing facilities and shorter stays for those who do spend time in such facilities reduced Medicare post-acute care spending for patients participating in the shared savings program by nine percent in 2014.

Learn more about the study in this article in this McKnight’s Long-Term Care News article or go here to see the JAMA Internal Medicine study “Changes in Postacute Care in the Medicare Shared Savings Program.”…

GAO Looks at Telehealth

With growing interest in using telehealth, or telemedicine, to serve patients in geographically remote or underserved areas, the U.S. Government Accountability Office, operating under a mandate from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), has examined potential barriers to the use of this relatively new form of care.

Among the barriers it found were cultural issues, inadequate licensure, lack of coverage (and reimbursement) for such services, and access and provider training issues.

GAO offered no recommendations for addressing these challenges.

Learn more about GAO’s findings by going here to see the report Telehealth and Remote Patient Monitoring Use in Medicare and Selected Federal Programs.


Health Reform Helps Hospitals in Medicaid Expansion States

The Affordable Care Act’s enhancement of access to health insurance, whether through Medicaid expansion or the subsidization of insurance premiums for working-class and some middle-class Americans, has improved the financial health of hospitals.

Especially hospitals in Medicaid expansion states.

According to a new report from the Urban Institute,

Using data through fiscal year 2015, this new analysis finds that the Medicaid expansion under the ACA increased Medicaid revenue by $5.0 million per hospital, reduced costs of uncompensated care by $3.2 million per hospital, and improved average operating margins by 2.5 percentage points. This study also finds that the financial benefits of the Medicaid expansion on hospitals’ profit margins were strongest for small hospitals, for-profit and non-federal-government-operated hospitals, and hospitals located in nonmetropolitan areas.

To learn more, go here to find the new Urban Institute report “How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data.”…

Medicaid Work Requirements

Both Congress and a number of states have discussed introducing work requirements into their Medicaid programs.  Such a proposal was part of the American Health Care Act, a number of governors and state legislators have discussed work requirements as a condition of Medicaid eligibility, and some states are reportedly considering including such requirements in section 1115 Medicaid waiver applications.

In a new report, the Congressional Research Service examines the U.S. Department of Health and Human Services’ authority to grant such waivers and how courts might look at such requirements if they were be contested.

Go here to see the Congressional Research Service report “Judicial Review of Medicaid Work Requirements Under Section 1115 Demonstrations.”

Medicaid Per Capita Caps Explained

In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to resurface in the near future.

Among other things, the article

  • explains what per capita caps are and how they would work
  • describes how per capita caps differ from current Medicaid policy
  • considers how the implementation of per capita caps might affect low-income people, providers, and insurers

Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid Per Capita Caps,” which can be found here.…