Stakeholders Respond to CMS “Patients Over Paperwork” RFI

More than 400 stakeholders responded to the federal government’s request for ideas to reduce the administrative burden associated with serving publicly insured patients.

The request was disseminated via a Centers for Medicare & Medicaid Services request for information that was part of the agency’s “Patients over Paperwork” initiative.  Among the groups that responded were the American Hospital Association, The American Association of Colleges of Nursing, the Critical Access Hospital Coalition, the Coalition of Long-Term Acute-Care Hospitals, the National Rural Association of Rural Health Clinics, the American Academy of Ophthalmology, the American Academy of Family Physicians, the American Hospital Association, and others.

Among the suggestions they offered were reconsideration of quality  metrics, changes in the merit-based incentive payment system (MIPS), the inclusion of social determinants of health in quality metrics, changes in star rating systems, greater efficiency in prior authorization processes, changes in interoperability requirements, and others.

Learn more about who submitted comments in response to this RFI and what they proposed in their comments in the Healthcare Dive article “CMS says it wants to cut paperwork. Providers have ideas.”

Surprise Medical Billing Problem Growing Worse

Insured patients are getting more surprise medical bills, and more expensive surprise medical bills, even as Congress attempts to tackle this problem.

According to a new study, 42.8 percent of emergency department patients now receive surprise medical bills for out-of-network services, up from 32.3 percent in 2010, with those surprise bills rising from a mean of $220 in 2010 to $628 in 2016.

Patients experience similar frustrations with inpatient visits, with surprise bills for out-of-network services arriving in the mailboxes of 42 percent of patients in 2016, up from 26.3 percent in 2010.  Those surprise bills rose from a mean of $804 in 2010 to $2040 in 2016.

The most common reason for a surprise medical bill?  Ambulance service, with more than 85 percent of patients who arrive at a hospital emergency department via ambulance receiving a surprise bill and more than 81 percent of patients served on an inpatient basis who use ambulances receiving such bills.

Learn more about how the surprise medical bill problem continues to grow, despite state and federal efforts to address it, in the JAMA Internal Medicine study “Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals.”


New Public Charge Rule Could Affect Immigrants, Providers

Legal immigrants may become reluctant to seek government-sponsored health care and providers may find themselves delivering more uncompensated care in the wake of the adoption of a new federal “public charge” regulation that seeks to define more narrowly the kinds of individuals who should be granted entry to the U.S. in the future.

The new Department of Homeland Security regulation, while focused on applicants for entry into the U.S., could have the unintended effect of discouraging legal immigrants from enrolling in Medicaid, CHIP, and other government programs and even lead them to disenroll from such programs out of a mistaken concern that participating in such programs could jeopardize their status as legal immigrants.  The Kaiser Family Foundation, in fact, estimates that two to three million people will leave Medicaid and CHIP because of the new regulation.

More than a quarter of a million interested parties responded to the proposed regulation, which was published last October, and since its release last week a wide variety of groups, ranging from the American Hospital Association and America’s Essential Hospitals to the American Council of Pediatrics, have noted the new regulation’s potential impact with alarm.  Hospitals, in particular, are concerned that if people disenroll …

Can Medicare Feed its Way Out of Some Readmissions?

Feeding some Medicare patients after they are discharged from the hospital could reduce readmissions and save taxpayers millions, a new study has concluded.

According to the new Bipartisan Policy Center report Next Steps in Chronic Care:  Expanding Innovative Medicare Benefits, providing a limited number of free meals to certain Medicare patients could eliminate nearly 10,000 readmissions a year and save more than $57 million.

Participating patients would be those with more than one of a limited number of chronic medical conditions and the meals would be for one week only.  According to the report, more than 575,000 Medicare beneficiaries would be eligible to participate in such a program, with their meals costing $101 million a year, or $176 a person for one week, but the nearly 10,000 Medicare readmissions that would be prevented would reduce Medicare spending more than $158 million a year.

Such a program, if implemented, would be yet another approach to addressing the social determinants of health in many communities.

Learn more about how such an approach would work and whom it would serve in the Bipartisan Policy Center report Next Steps in Chronic Care:  Expanding Innovative Medicare Benefits.…

Update Patient Satisfaction Survey, Hospital Groups Suggest

The survey that asks patients about their satisfaction with their hospital experience should be revised, several hospital groups have declared.

The Hospital Consumer Assessment of Healthcare Providers and Systems survey has become outdated and needs revision, according to the Federation of American Hospitals, the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, and the Catholic Health Association of America.

According to the hospital groups, the 32-question HCAHPS survey needs to be updated to address more effectively matters involving value-based care, health care technology, patient priorities, and post-discharge transitional care.  The groups also called for the survey to be shortened and for it to be available for patients to respond to digitally.

Learn more in Modernizing the HCAHPS Survey:  Patient Experience Leaders Modernizing the HCAHPS Survey, the report that presents the hospital groups’ findings and recommendations.…