MedPAC finalizes 2015 hospital payment, LTCH reform recommendations   01/16/2014
The Medicare Payment Advisory Commission today approved a final recommendation that Congress increase Medicare payment rates for the hospital inpatient and outpatient prospective payment systems by 3.25% in 2015, noting that its recommendation is 5.25% if the sequester continues in 2015. The Commission also recommended that, concurrently, Congress reduce or eliminate payment differences between hospital outpatient departments and physician offices for selected procedures and pay long-term care hospitals the same rates as general acute-care hospitals for cases involving patients who are not deemed “chronically critically ill,” defined as an intensive care unit stay of at least eight days. Savings realized by cutting LTCH payments would be redistributed to create a new outlier pool for CCI cases treated in inpatient PPS hospitals. In a change from the draft recommendation, the LTCH policy would be phased in over three years. “We are pleased that MedPAC recommended a substantial update for hospitals in 2015, recognizing that even efficient hospitals will have negative margins,” said Linda Fishman, AHA senior vice president for public policy analysis and development. “However, we are troubled by the recommendation to reduce or eliminate payment differences between hospital outpatient departments and physician offices for 66 ambulatory payment classifications, which could threaten access to care for Medicare beneficiaries. In addition, the LTCH recommendation is at odds with the sweeping LTCH payment reforms recently enacted by Congress in the Bipartisan Budget Act, and we are troubled by the lack of analysis evaluating the consequences this recommendation would have on the LTCH field and the beneficiaries it serves.” For more information, see AHA’s recent letter to MedPAC.
House passes FY 2014 omnibus spending bill   01/16/2014
The U.S. House of Representatives last night voted 359-67 to approve a $1.1 trillion omnibus spending bill that will fund the government for fiscal year 2014. The legislation includes all 12 of the individual annual spending bills providing $1.012 trillion in discretionary funding for operating the federal government, fulfilling the guidelines of the Bipartisan Budget Act of 2013. It also provides $91.7 billion in overseas contingency operations funds. The departments of Labor, Health and Human Services, and Education portion of the omnibus bill includes $156.8 billion in discretionary funding, which is $100 million below the FY 2013 enacted level. The bill provides $29.9 billion for the National Institutes of Health, $1 billion more than FY 2013; $3.7 billion for the Centers for Medicare & Medicaid Services’ operation and management, a $195 million decrease from last year; $3.6 billion for the Substance Abuse and Mental Health Services Administration, $144 million more than last year; and $6.9 billion for the Centers for Disease Control and Prevention, an increase of $567 million. The Senate is expected to vote on the bill later this week. 
ACEP report urges support for hospital emergency departments, patients   01/16/2014
The American College of Emergency Physicians today gave the nation an overall grade of D+ when it comes to state and federal support for emergency care. That’s down from a C- issued by the group in 2009. According to ACEP, the report card “measures conditions and policies under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers.” Each state and the nation are graded based on 136 measures in five categories: access to emergency care; quality and patient safety; medical liability environment; public health and injury prevention; and disaster preparedness. The national grade for access to emergency care was D-. “It reflects that hospitals are not getting the necessary support in order to provide effective and efficient emergency care,” said Jon Mark Hirshon, M.D., chair of the task force that developed the report. Among other recommendations, the report calls for federal and state lawmakers to protect access to emergency care as health care reforms are implemented; enact medical liability reforms that enhance timely access to quality care; and adequately fund disaster preparedness and graduate medical education programs.
HRRP may have unintended consequences for vulnerable populations   01/16/2014
Hospitals that treat more poor seniors who are on both Medicaid and Medicare tend to have higher rates of readmissions, triggering costly penalties under the Hospital Readmissions Reduction Program, according to a new study published online by Health Services Research. Both patient dual-eligible status and a hospital’s dual-eligible share of Medicare discharges were found to increase risk-adjusted hospital readmission rates. “As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations,” the study adds. “Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations.” AHA staff members were coauthors on the study.
HHS issues health IT safety guides   01/16/2014
The Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology yesterday released nine guides intended to help health care providers and others assess and optimize the safety and safe use of electronic health records. Developed by health IT safety and informatics researchers with input from stakeholders, the guides include self-assessment checklists and other tools and address the following topics: high priority practices; organizational responsibilities; patient identification; computerized physician order entry; test results review and follow-up; clinician communication; contingency planning; system interfaces; and system configuration. The Safety Assurance Factors for EHR Resilience (SAFER) Guides are available at www.HealthIT.gov/saferguide and on the AHA’s Hospitals in Pursuit of Excellence website.
HFMA issues 'best practices' for medical debt collection   01/16/2014
The Healthcare Financial Management Association yesterday issued “best practices” for medical debt collection. Developed by a task force of health care providers and others convened by HFMA and ACA International (Association of Credit and Collection Professionals), the practices seek to provide patients with a thorough understanding of what to expect during the payment and collection process. They call for developing consistent, coordinated policies for account resolution so collection agencies and others are governed by a provider’s board-approved policies; developing appropriate channels and practices for patient communications and account resolution; reporting back to credit bureaus when accounts are resolved; and tracking consumer complaints. For more information, visit www.hfma.org/medicaldebt.
PA hospital wins 2013 Foster McGaw Prize   01/16/2014
Crozer-Keystone Health System in Delaware County, PA, today received the 2013 Foster G. McGaw Prize for Excellence in Community Service for its broad-based efforts to improve the lives of the most vulnerable members of its community. “The system’s exemplary community benefit programs address the entire lifespan – from programs that target the reduction of infant mortality to programs that support, educate and enable seniors to remain in their homes as long as possible,” said John O'Brien, prize committee chair. “The main county that Crozer-Keystone serves has no county health department, making the system’s leadership role in community health improvement of vital importance to vulnerable – and all – area residents.” The Baxter International Foundation, AHA and Health Research & Educational Trust sponsor the annual $100,000 prize. Named as finalists for this year's award and receiving $10,000 each are: North Shore-LIJ Health System in Great Neck, NY; Memorial Hermann Health System in Houston; and St. Joseph Health, Queen of the Valley Medical Center in Napa, CA.
AHA small/rural section names leaders   01/16/2014
Paul Bengtson, CEO of Northeastern Vermont Regional Hospital in St. Johnsbury, VT, will lead the AHA's Section for Small or Rural Hospitals in 2014. Bengtson will chair the section's governing council, which represents small or rural hospitals in the AHA's policy process and member services initiatives. Joann Anderson, president and CEO of Southeastern Regional Medical Center in Lumberton, NC, is the section's 2014 chair-elect and will become chair in 2015. For more on the section's governing council, see the AHA news release.
Hospitals given extra week to complete AHA RACTrac survey   01/16/2014
The AHA has extended to Jan. 24 the deadline for hospitals to submit data to its quarterly RACTrac survey. The free web-based survey helps AHA gauge the impact of Medicare's Recovery Audit Contractor program on hospitals and advocate for needed changes. To register for the survey or for technical assistance, participants should contact RACTrac support at (888) 722-8712 or ractracsupport@providercs.com. For more on the survey, including the latest results, visit www.aha.org/ractrac.