Archive for July, 2017


CMS Takes First Steps Toward Medicaid DSH Cuts

Federal funds allocated to states to make Medicaid disproportionate share hospital payments (Medicaid DSH) payments would be reduced beginning in FY 2018 under a new rule proposed by the Centers for Medicare & Medicaid Services.

The Medicaid DSH cuts, mandated by the Affordable Care Act but delayed several times at the behest of Congress, would come in the form of reduced Medicaid DSH allocations to individual states, with the size of those allocation cuts based on the nature of individual states’ Medicaid programs and changes in the number of uninsured patients in individual states.

The cuts were established in the Affordable Care Act based on the assumption that enhanced access to health insurance would result in hospitals serving fewer uninsured patients and therefore needing fewer Medicaid DSH resources.

The proposed regulation calls for $43 billion in savings between 2018 and 2025, a target set in the enabling legislation.

Learn more about the CMS proposal for reducing state Medicaid DSH allocations in this article in Becker’s Hospital Review or see the draft regulation itself here.

Interested parties have until August 28 to submit written comments to CMS.…

Behavioral Health Services in Medicaid Expansion States

The U.S. Government Accountability Office has performed a limited study of the utilization of Medicaid behavioral health services in Medicaid expansion states.

The study, based on data from New York, Washington, Iowa, and West Virginia, found that the two most heavily utilized behavioral health services were diagnostic and psychotherapy services and that more than two-thirds of behavioral health patients were prescribed anti-depressants.  More people sought help for mental health challenges that for substance abuse problems.

Medicaid officials in the selected states concluded that enrollment in Medicaid enhanced access to behavioral health care.

Learn more about the study’s findings in the GAO report Medicaid Expansion:  Behavioral Health Treatment Use in Selected States in 2014, which can be found here.…

Ways and Means Seeks to Cut Medicare Red Tape

The House Ways and Means Committee’s Health Subcommittee has launched a new initiative to attempt to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.

The subcommittee describes its “Medicare Red Tape Relief Project” as

…a new initiative to deliver relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries.

In support of this initiative, the committee has announced a three-part approach in which it will seek feedback from stakeholders, host roundtables with stakeholders across the country, and pursue congressional action to address the problems identified through this process.

As part of the first step, the Health Subcommittee is inviting stakeholders to submit information about regulatory and statutory obstacles they have encountered and how they believe the federal government should address those obstacles.

Learn more about the Medicare Red Tape Relief Project and how stakeholders can report problems and recommend improvements from this subcommittee news release.…

Study Finds Communication Woes That Pose Risks for the Elderly

Inadequate communication between doctors and home health providers unnecessarily puts elderly patients at risk, a new study has found.

At the heart of this problem are lack of access to physician information for home health workers, challenges home providers face when seeking to order new services, lack of accountability among physicians, and poor transitions between hospitalists and patients’ primary care doctors.

Learn more about these challenges and ways to address them in the study “’Connecting the Dots’: A Qualitative Study of Home Health Nurse Perspectives on Coordinating Care for Recently Discharged Patients,” which can be found here, in the Journal of General Internal Medicine.…

GAO Looks at Use of Telehealth in Medicare, Medicaid

The U.S. Government Accountability Office has examined the use of telehealth services in the Medicare and Medicaid programs.

In a study that looked at current Medicare practices, sampled Medicaid practices in six states, and consulted selected provider, payment, and patient associations, the GAO evaluated the extent to which telehealth is used in Medicare and Medicaid today, factors that affect the use of telehealth in Medicare, and the degree to which new payment and delivery models might affect future telehealth utilization in Medicare.  The report does not offer recommendations.

The GAO released its findings in a new report titled Telehealth:  Use in Medicare and Medicaid.  Find it here.…