A federal program that tested a new approach to the delivery of Medicare services to high-risk patients delivered on its promise to improve the quality of care for patients but did not reduce the cost of caring for those patients.

The Centers for Medicare & Medicaid Services’ Comprehensive Primary Care Initiative improved access to care for patients in more than 500 participating medical practices and reduced their ER visits two percent but did not reduce Medicare’s cost for caring for these patients.  After several years in effect the program, which features enhanced care management for high-risk patients, improved coordination of care, and enhanced access to services, also achieved more timely post-discharge care.

A significant majority of participating doctors, while observing that the program’s reporting requirements were burdensome, also believed that the program improve the quality of care.

Learn more about this evaluation of Medicare’s Comprehensive Primary Care Initiative here, in the Health Affairs report “The Comprehensive Primary Care Initiative: Effects On Spending, Quality, Patients, And Physicians,” or go here for a summary of the report on the Healthcare Dive web site.…

The section 340B prescription drug discount program has grown increasingly controversial in recent years.

The program, established in the 1990s to help hospitals with the cost of the prescription drugs they provide to low-income patients on an outpatient basis, has grown considerably since its inception.  Pharmaceutical companies argue that it is too large, that it contributes to the growing cost of prescription drugs, and that hospitals are not using the savings they reap from the program to serve more low-income patients, as was envisioned when Congress created the program.

Eligible providers, on the other hand, note that much of the program’s growth was mandated by Congress and that 340B continues to serve its original purpose of helping hospitals serve low-income outpatients while using the savings the program generates to provide even further assistance to low-income patients.

Recent federal efforts to address some of these issues have satisfied neither side.

The Vox news web site has published an article that describes the program and outlines both sides of the argument.  Find it here.…

A new report published on the Health Affairs Blog describes the continuing challenges safety-net hospitals face and offers suggestions for helping them meet those challenges.

The challenges, according to the report, are the virtual elimination of the Affordable Care Act’s individual health insurance mandate; the continued decline in the amount of Medicare disproportionate share hospital money (Medicare DSH) provided to safety-net hospitals; and hospital closures that shift more of the burden for caring for uninsured patients onto a smaller pool of safety-net hospitals.  The result is under-served patients and new financial risks for the hospitals that remain after some safety-net hospitals close because of the large amounts of uncompensated care those hospitals continue to provide.

To address these challenges, the report offers three potential solutions:

• Congress should revisit the Medicare DSH cuts.
• States should target their DSH money to the hospitals providing the most uncompensated care.
• Non-profit non-safety-net hospitals that stabilize uninsured emergency patients and then direct them to safety-net hospitals should be required to play a longer-term role in the care of such patients as part of their required community benefit or risk losing their tax-exempt status.

Learn more about the challenges safety-net hospitals continue to face and some …

The U.S. Department of Health and Human Services has published a comprehensive list of the regulatory actions it plans to take in the coming months.

Included on the list are regulations that have been proposed, that are being finalized, and that are currently under development.  They address Medicare, Medicaid, Food and Drug Administration endeavors, medical devices, the 340B prescription drug discount program, and more.

Among the policy changes contemplated through future regulations are measures to reduce regulatory burdens for hospitals, address the opioid problem, facilitate the use of non-Affordable Care Act-compliant health insurance plans, and more.

Go here to see a complete list of the areas for proposed regulatory action by HHS and for links to brief statements about the contemplated actions.…

The Centers for Medicare & Medicaid Services had introduced what it calls its “first rural health strategy.”

According to the agency, the purpose of the strategy is

…to provide a proactive approach on healthcare issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable healthcare.

“For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” said CMS Administrator Seema Verma. “The Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and our continued stakeholder engagement, this strategy will enhance the positive impacts CMS policies have on beneficiaries who live in rural areas.”

CMS explains that its strategy,

…built on input from rural providers and beneficiaries, focuses on five objectives to achieve the agency’s vision for rural health:

• Apply a rural lens to CMS programs and policies
• Improve access to care through provider engagement and support
• Advance telehealth and telemedicine
• Empower patients in rural communities to make decisions about their healthcare
• Leverage partnerships to achieve the goals of the CMS Rural Health Strategy

Learn more about CMS’s rural health strategy by visiting …