Healthcare Reform News
9 HEALTH CARE REFORM CHANGES 2012
2012 kicks-off rapid changes to health care reform. Please share this with your management and staff.Read more... For more Healthcare Reform News
CMS RELEASES FINAL CoP, REGULATORY BURDEN REDUCTION RULES
CMS released two final rules to streamline requirements for hospital participation in Medicare and Medicaid. The final rule addresses more than two dozen regulatory requirements for a broader range of providers, including hospitals, ambulatory surgical centers, end-stage renal disease facilities and durable medical equipment suppliers.Read more...
Week Of May 14, 2012
CMS EXPANDS MEDICAL STAFF DEFINITION TO INCLUDE APRNS, PAS
CMS expanded its definition of the medical staff, allowing non-physician practitioners to have privileges like other medical staff members. In an effort to cut some outdated requirements, CMS changed rules about medical staff oversight and roles.Read more...
NEW RULE WOULD BRING MEDICAID PAYMENTS FOR PRIMARY CARE IN LINE WITH MEDICARE’S
CMS issued a proposed rule implementing a Patient Protection and Affordable Care Act requirement that Medicaid pay primary care physicians at least as much as Medicare for certain services provided in calendar years 2013 and 2014.Read more...
INCREASED ACCESS TO PRIMARY CARE PROVIDERS
Increased access to primary care is a central feature in the Affordable Care Act (ACA): it includes increased pay for primary care providers (PCPs), expansion of medical homes and accountable care models that put population management in control of primary care, and more. See chart.Read more...
RETIRED COUPLES MAY NEED $240,000 FOR HEALTH CARE
Couples retiring this year can expect their medical bills throughout retirement to cost 4 percent more than those who retired a year ago, according to an annual projection released by Fidelity Investments.Read more...
NQF ENDORSES ALL-CAUSE UNPLANNED READMISSIONS MEASURES
The National Quality Forum (NQF) board of directors has endorsed two measures that address all-cause unplanned readmissions in hospitals.SIXTEEN ORGANIZATIONS CHOSEN FOR INDEPENDENCE AT HOME ACT DEMONSTRATION
The Department of Health and Human Service announced the 16 organizations that have been chosen to participate in the Medicare demonstration project called Independence at Home. The program coordinates a range of in-home primary care services for chronically ill Medicare beneficiaries. The program is set to start on June 1, 2012, and conclude May 31, 2015.
MEDICARE’S PROPOSED PAYMENT RULE AFFECTS POST-ACUTE SERVICES
The new proposed rule would strengthen the Hospital Value-Based Purchasing Program (VBP Program) to further Medicare’s transformation from a system that rewards volume of service to one that rewards efficient, high-quality care.EMPLOYERS, INSURERS EMBRACING TELEHEALTH, BUT BARRIERS REMAIN
More health insurers and employers are beginning to offer virtual physician visits via telehealth technology as a way to curb costs and improve access to care.ENROLLMENT STILL GROWING IN MEDICARE ADVANTAGE PLANS
Enrollment in Medicare Advantage plans rose to 8.4 million beneficiaries in April 2011, about a 6 percent increase from April 2010, according to a report from the Government Accountability Office.
NEW MEDICAID REGULATIONS GIVE STATES FLEXIBILITY WITH HOME AND COMMUNITY BASED SERVICES
State Medicaid programs have been granted additional flexibility in providing home- and community-based services to elderly and disabled individuals, according to new regulations. CMS has issued two final rules governing how states spend Medicaid funds on home and community based services (HCBS). The first rule, known as the Home and Community-Based State Plan Services Program and Provider Payment Reassignments, lifts existing “cumbersome” eligibility requirements on HCB...
CMS NAMES 27 MEDICARE ACOS
CMS announced the first 27 accountable care organizations to participate in the voluntary Medicare Shared Saving Program. Beginning this month, the selected organizations will be responsible for improving care for nearly 375,000 beneficiaries in 18 states through better coordination among providers.
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Special Reports And Articles
Medicaid 2013 Governor's Report
Medicaid 2013 Governor's Report By State
MedPAC Report 2012
MedPAC, the Committee that reports to Congress's Home Care recommendations
Read the Report
Home Care Recommendations To Congress
Post-Acute Payment Reform Demonstration
The report describes the development and testing of a uniform patient assessment instrument (CARE: Continuity Assessments Record and Evaluation) mandated by the legislation, and reviews findings related to predicting patient-specific resource intensity across four post-acute care settings. Recommends future payment reform for post-acute settings.
Readmissions
A Nationwide Analysis Of 30-Day Readmits
( Nov/Dec 2011 Remington Report page 4)
Download Dartmouth Atlas Report (3.8 MB PDF)
Study: Home Care Following Hospitalization Cuts Cost
(Sept/Oct issue 2011 Remington Report page 4)
The use of home health care for chronically ill patients after they are discharged from the hospital can reduce Medicare spending and readmissions, according to released by Avalere Health LLC. The study found that home health care was association with a $2.81 billion reduction in Medicare Part A spending during a three-year period ending in 2009.Click here for study.
2012 OIG Work Plan
The Remington Report (November/December 2011) separated the OIG Work Plan 2012 into 2-parts. Part 1 looks at the OIG Plan for home care. Part 2 reviews the Plan with respect to how its scope intersects with home care and other providers across the health care delivery system.
Download the detailed 165-page 2012 OIG Work Plan Report (2.2 MB PDF)
Dual Eligibles
Will Medicare Become Responsible For Dual Eligibles?
COLLABORATIVE MODELS - Special Reports
Integrated Solutions To Patient Care
Sponsored by Hill-Rom
Health Care Reform: Supply Management Systems Alignment
Sponsored by Medline