Archive for hospitals

 

“Hospital at Home” Growing

The concept of treating “hospitalized” patients at home could play a more prominent role in the delivery of hospital services in the coming years.

Hospital at home programs have been around for decades but took on greater importance when COVID-19 began filling hospital beds.  With many communities experiencing a shortage of beds, the Centers for Medicare & Medicaid Services issued an “acute hospital care at home waiver” in November of 2020 to help compensate for the bed shortage and encourage home programs.  Now that the COVID crisis has passed, health care interests are not necessarily moving away from the idea of providing hospital-like care to some patients in their own homes.

The case for hospital care at home can be compelling.  Some communities – especially those in rural areas – lack hospital beds or even hospitals at all; recovery at home eliminates the risk of hospital-acquired infections; and one study found that patients who received their hospital care at home were “discharged” from care faster and experienced fewer post-discharge emergency department visits and hospital readmissions.  The concept of hospital care at home is already in use in other countries and one analysis suggests that hospital care at home could account …

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22.  Some of the language used below is taken directly from government documents.

Congress

As of this writing, Congress continues to work on an FY 2023 omnibus spending bill:  the Senate has passed it but the House has not yet addressed it.  Highlights of what negotiators have agreed to – but that have not yet been adopted – include:

  • Preventing the additional four percent Medicare sequester for two years.
  • Reducing by more than half the 4.5 percent cut in Medicare payments to physicians that was scheduled to take effect on January 1.  The agreement calls for reducing that 4.5 percent cut to just two percent in 2023 and then imposing a 3.5 percent cut in 2024.
  • Extending COVID-19 public health emergency Medicare telehealth policies for two years, through 2024.
  • Ending the maintenance-of-effort requirement from the Families First Coronavirus Response Act that prohibited states from removing ineligible individuals from their Medicaid rolls.  Under that law, states were prohibited from reviewing the eligibility of Medicaid beneficiaries for the duration of the COVID-19 public health emergency in exchange for a 6.2 percentage point increase in FMAP. 

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents.

White House

  • The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House press briefing about the plan.

Congress

  • Yesterday the House passed a one-week continuing resolution (CR) that will prevent the federal government from shutting down when the current CR ends tomorrow, December 16; the Senate will take up that bill although some senators have expressed their objection to a short-term CR.  Appropriators have agreed on the spending limits for FY 2023 spending bills and hope to pass an omnibus spending bill encompassing all 12 appropriations bills before next Friday, December 23.  House minority leader Kevin McCarthy, backed by other House Republicans, objects to passing an omnibus spending bill before the end of

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The December 2022 MACPAC meeting began with a Commission discussion on two potential recommendations for improving Medicaid race and ethnicity data reporting. As part of its commitment to prioritizing health equity in all of its work, the Commission is focused on how to improve Medicaid race and ethnicity data collection and reporting. In October, staff presented findings from a literature review and key stakeholder interviews, as well as possible approaches for improving the collection and reporting of these data. In this presentation, staff reviewed the state data collection and reporting processes, data quality priorities, and barriers to improvement. Staff also presented two potential recommendations for the Commission’s consideration, with the goal of making recommendations in MACPAC’s March report to Congress. The Commission will vote on these recommendations in January 2023.

Next, the Commission discussed two potential recommendations to improve the transparency of nursing facility payment data. The Commission has undertaken long-term work to examine the extent to which Medicaid nursing facility payment policies are consistent with the statutory goals of efficiency, economy, quality,

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week.

During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated:

  • Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes.  Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.”
  • Status report: ambulatory surgical center services.
  • Assessing payment adequacy and updating payments: physician and other health professional services; and supporting Medicare safety-net clinicians – commissioners discussed increasing physician and health professional provider rates in general and increasing them even more for those who care for larger numbers of low-income Medicare patients.
  • Assessing payment adequacy and updating payments: outpatient dialysis services – commissioners discussed increasing these payments 1.5 percentage points.
  • Assessing payment adequacy and updating payments: hospice services.
  • Assessing payment adequacy and updating payments: skilled nursing facility services – commissioners discussed reducing these payments three percentage points.
  • Assessing payment adequacy and updating payments: home health care services – commissioners