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AHA comments on Ways and Means discussion draft   12/18/2014
AHA today expressed its appreciation for the health care-related discussion draft released last month by House Committee on Ways and Means Subcommittee on Health Chair Kevin Brady (R-TX), saying the proposals are “deserving of serious and thoughtful consideration and discussion.” AHA Executive Vice President Rick Pollack voiced support for some of the proposals but noted others “raise significant concerns or need clarification or modification.” Specifically, he expressed AHA’s strong objection to any proposals that would cut hospital payments. The draft includes items on Medicare’s recovery audit contractor program, “two-midnight” policy and short inpatient stays; the Centers for Medicare & Medicaid Services’ 96-hour physician certification requirement for critical access hospitals; adjustments to the Hospital Readmissions Reduction Program; and physician self-referral to hospitals in which they have an ownership interest, among other topics. AHA expressed appreciation for the committee’s attempt to offer a solution to issues related to patient status determinations, the two-midnight policy and the overwhelming number of claims in the appeals process, but noted the proposal “is complex, confusing and administratively burdensome.” In addition, it said many of the RAC-related proposals “fall far short of what will be necessary to reduce excessive and inappropriate denials by RACs and alleviate the administrative and financial burden the RAC program imposes on hospitals and the administrative appeals process.” AHA urged the committee to consider additional fundamental RAC program reforms.
AHRQ releases health literacy tool for pharmacies   12/18/2014
The Agency for Healthcare Research and Quality has released standardized instructions for pill administration in six languages to help patients understand and adhere to medicine regimens and reduce possible errors. Developed and tested by researchers, the instructions follow the Universal Medication Schedule, which simplifies complex medicine regimens by using standard time periods for administration (morning, noon, evening and bedtime). The instructions are available in English, Chinese, Korean, Russian, Spanish and Vietnamese. “While every effort was made to ensure accuracy and reliability of these translations, each pharmacy and pharmacist should confirm the validity and the medical appropriateness of any given translation for a particular patient before using it for the patient's drug label,” the agency said. For additional health literacy tools for pharmacies, visit AHRQ’s Pharmacy Health Literacy Center.
CMS releases final FY 2015 HAC data; AHA recommends program changes   12/18/2014
The Centers for Medicare & Medicaid Services today updated the Hospital Compare website with final data for calculating fiscal year 2015 payment reductions under the Hospital-Acquired Condition Reduction Program. In comments submitted today on a recent CMS-commissioned evaluation of the HAC Reduction Program’s scoring approach, AHA urged the agency to address significant shortcomings in the program’s scoring methodology. “America’s hospitals are deeply committed to reducing preventable patient harm, but are concerned that the HAC program fails to recognize hospitals for improvement and disproportionately penalizes hospitals caring for our nation’s sickest patients,” wrote Linda Fishman, AHA senior vice president for public policy analysis and development. She said, “Improving the HAC program’s measures would result in a fairer program for all hospitals. Yet the sole policy recommendation in the draft report focuses on an issue that affects only six of the more than 3,300 hospitals eligible for the HAC Reduction Program.” The letter strongly urges CMS to address “other more significant and meaningful issues in the HAC program,” such as identifying alternatives to the problematic PSI 90 measure and eliminating the overlap between HAC and value-based purchasing measures.
CMS: 9.7 million enroll in Medicaid/CHIP over 13 months   12/18/2014
Nearly 9.7 million people enrolled in Medicaid or the Children’s Health Insurance Program between Oct. 1, 2013 and Oct. 31, 2014, increasing total enrollment in the programs by nearly 17%, according to a report released today by the Centers for Medicare & Medicaid Services. The preliminary estimate is based on 48 states and the District of Columbia reporting both October enrollment data and baseline data from July through September 2013. A total of 67.5 million people were enrolled in Medicaid or CHIP in those states as of Oct. 31, with Medicaid expansion states showing a 24% increase and non-expansion states showing a 7% increase. About 428,000 people enrolled in Medicaid or CHIP in October. Medicaid and CHIP enrollment continues year round.
MedPAC considers inpatient, outpatient, LTCH updates for 2015   12/18/2014
The Medicare Payment Advisory Commission today considered a package of draft recommendations to Congress that would affect the inpatient, outpatient and long-term care hospital prospective payment systems. The recommendations would increase payment rates for the hospital inpatient and outpatient PPSs by 3.25% in 2015; reduce or eliminate payment differences between hospital outpatient departments and physician offices for selected procedures; and pay LTCHs the same rates as general acute-care hospitals for patients who are not deemed “chronically critically ill” by having an intensive care unit stay of at least eight days. The savings realized by cutting payments to LTCHs would be redistributed to create a new outlier pool for CCI cases treated in inpatient PPS hospitals. A separate session on the LTCH payment system and update is scheduled for tomorrow. The commission also considered a draft recommendation that would freeze Medicare payments to physicians in 2015 in place of the sustainable growth rate formula, and establish a prospective per beneficiary payment to replace the Primary Care Incentive Payment Program after it expires at the end of 2015. Lastly, the commission discussed recommendations that would maintain current payments for ambulatory surgical center and outpatient dialysis services. “The AHA is pleased that the commission has recognized the substantial challenges facing hospitals in the coming years and provided a positive payment update," said Joanna Hiatt Kim, AHA vice president of payment policy. “However, we continue to be concerned by the commission’s draft recommendation to reduce or eliminate payment differences between hospital outpatient departments and physician offices for selected procedures, which is based on data from 2010 and does not consider the sweeping changes made to the outpatient payment system for calendar years 2014 and 2015. In addition, we are troubled by the LTCH recommendation, especially given the lack of information about its financial impact on LTCHs and, most importantly, potential consequences for beneficiary access to the high-quality, specialized care that LTCHs provide.
Representatives urge HHS to shorten 2015 EHR reporting period now   12/18/2014
Thirty members of Congress are urging the Department of Health and Human Services to immediately provide a shortened, 90-day reporting period for hospitals and eligible professionals participating in the Medicare and Medicaid Electronic Health Record Program in 2015. “We recognize that the Meaningful Use Program has been a catalyst in the widespread adoption of health information technology across the country,” the representatives said in a Dec. 16 letter to HHS Secretary Sylvia Burwell. “However, we remain convinced that program success hinges on addressing the 2015 reporting period requirements….The additional time granted through a 90-day reporting period is vitally important to ensure that hospitals and physicians continue moving forward with technology to improve patient care.” They urged Burwell to respond within 30 days, noting that the current 365-day reporting period commenced Oct. 1 for hospitals and begins Jan. 1 for physicians.
Winter edition of Great Boards newsletter available   12/18/2014
The winter 2014 issue of the Great Boards newsletter is now available and focuses on two issues: how health care organizations can align their governance structure with their business model and evaluating incentive compensation plans for executives. Administered by AHA's Center for Healthcare Governance, the free quarterly newsletter examines hospital and health system governance trends and effective practices. To subscribe, click here. For additional tools and resources for hospital boards of trustees, visit AHA's Great Boards website.
257,000 EPs to receive EHR penalties   12/17/2014
According to the Centers for Medicare & Medicaid Services, starting in January, nearly 257,000 eligible professionals will receive penalties for failure to demonstrate meaningful use of electronic health records under the Medicare EHR Incentive Program in a prior year. The penalties will be assessed on the EPs’ Medicare Physician Fee Schedule payments. CMS is sending out penalty notices to affected EPs containing information on how to file for a reconsideration. The instructions are also available on the CMS website. “These wide-spread physician penalties reflect the many challenges providers face with the meaningful use program,” said Chantal Worzala, AHA director of policy for health information technology. “Hospitals cannot be successful without their physician partners. It is time for CMS to address providers’ concerns about the program.”
CDC: 12.2% of U.S. residents uninsured, down from 14.4% last year   12/17/2014
An estimated 12.2% of U.S. residents (38 million) were uninsured when interviewed in the first six months of 2014, down from 14.4% (44.8 million) in 2013 and 16% (48.6 million) in 2010, according to a report released yesterday by the Centers for Disease Control and Prevention’s National Center for Health Statistics. The 2014 estimate includes 17% of adults under age 65 and 6.1% of children. The report updates estimates for 15 selected health measures based on the January-June 2014 National Health Interview Survey and presents estimates for 1997 through 2013 for comparison.
HHS: Nearly 2.5 million enrolled in 2015 federally-facilitated Marketplace   12/17/2014
Nearly 2.5 million individuals and families selected a health plan through the federally-facilitated Health Insurance Marketplace between Nov. 15 and Dec. 12, nearly half of them for the first time, according to preliminary data released yesterday by the Department of Health and Human Services. More than 1 million people signed up last week as the Dec. 15 deadline for coverage that starts Jan. 1 approached. Open enrollment in the Marketplace runs through Feb. 15.