AHA briefing highlights legislative priorities to protect patient access to care   01/23/2014
Hospitals cannot sustain further payment cuts without jeopardizing patients’ access to needed care, AHA representatives told reporters today during a telephone briefing on its legislative agenda. As Congress looks for savings and potential offsets for physician payment reform and other spending, AHA is urging lawmakers to protect hospital payments, provide relief from excessive and harmful policies, and support rural health care, said Tom Nickels, AHA senior vice president of federal relations. Hospitals have already absorbed $113 billion in new legislative and regulatory cuts to Medicare and Medicaid payment since 2010, and face mounting pressure from a huge array of policy changes, such as Medicare’s Recovery Audit Contractor program and two-midnight policy for inpatient admission and medical review criteria. Participating in the briefing, Steven Hanks, M.D., Hartford (CT) HealthCare’s vice president of medical affairs for the central region, said the five-hospital health system has had nearly $40 million in claims denied for medical necessity since December 2010, but that the vast majority have been overturned on appeal, a costly process that can take years. “It’s pretty clear RACs are just tossing a broad fishing net, because they’re not penalized,” Hanks said. Among other legislation, AHA supports the Medicare Audit Improvement Act (H.R. 1250/S. 1012) and Two Midnight Rule Delay Act (H.R. 3698).
Webcast on enrollment highlights best practices for hospitals   01/23/2014
AHA President and CEO Rich Umbdenstock and Department of Health and Human Services Secretary Kathleen Sebelius today hosted a webcast on the important role hospitals and health systems continue to play in enrolling their communities in health insurance marketplaces under the Patient Protection and Affordable Care Act. Sebelius praised hospitals and health systems, saying there is no better spokesperson and emphasizing their critical role in enrollment. Cynthia Taueg, vice president of ambulatory and community health services at St. John Providence Health System in Warren, MI, part of Ascension Health, and Judy Rich, CEO of Tucson (AZ) Medical Center, also shared examples of enrollment efforts and best practices, including low-cost strategies that hospitals and health systems can easily adopt. “We really are stressing the need to work with our partners,” said Taueg, touting successful enrollment partnerships with federally-qualified health centers, local health departments and libraries. Rich highlighted community events such as health fairs and education seminars that have helped the hospital reach more than 50,000 people since it started these activities in October. Umbdenstock closed the webcast by stressing that enrollment is truly an ongoing effort and hospitals and health systems will need to continue to play a huge leadership role, saying “the next 10 weeks are a critical time for us to enroll even more Americans.” A replay of the webcast will be available next week on www.aha.org/getenrolled.
CMS: 6.3 million Medicaid/CHIP applicants deemed eligible since October   01/23/2014
More than 6.3 million people were deemed eligible by state agencies to enroll in Medicaid or the Children’s Health Insurance Program between Oct. 1 and Dec. 31, according to a report released yesterday by the Centers for Medicare & Medicaid Services. The total includes people newly eligible under the Patient Protection and Affordable Care Act and those eligible under prior law. States reported about 2.3 million Medicaid/CHIP determinations in December, based on data from 46 states and Washington, D.C. “Looking at the 41 states that reported both December determinations and baseline data for this indicator, December determinations were up 73% as compared to the July through September 2013 period in states expanding Medicaid and up 3% in those states not expanding Medicaid,” the report adds.
Gallup index shows modest decline in uninsured since December   01/23/2014
The proportion of U.S. adults without health insurance has fallen 1.2 percentage points since Jan. 1, when the Patient Protection and Affordable Care Act requirement that Americans have health insurance took effect, according to the latest Gallup-Healthways Well-Being Index. At 16.1%, the uninsured rate for Jan. 2-19 is slightly lower than what Gallup has measured in any month since December 2012. According to the index, unemployed adults continued to have the highest uninsured rate, which fell by 6.7 percentage points since December to 34.1%. The index’ uninsured rate for adults under age 35 fell by 0.2 percentage point, to 24.5%. According to an analysis released today by the Robert Wood Johnson Foundation, 55% of uninsured adults under age 65 who were surveyed in September thought they would remain uninsured in 2014, in part because they inaccurately believe they are ineligible for Medicaid or subsidies to purchase insurance. “The survey respondents’ relative lack of knowledge about the availability of free or subsidized health insurance illustrates the need for increased outreach,” said Katherine Hempstead, who leads coverage issues at the Foundation.
Reminder: Complete IFD, HRET diversity survey by Jan. 31   01/23/2014
The Institute for Diversity in Health Management and the Health Research & Educational Trust encourage all hospital leaders to complete a survey about their efforts to address health care disparities and improve diversity management practices. The survey was mailed to hospital CEOs, and all hospitals are encouraged to complete the survey by Jan. 31. For more information, contact Kevin Kenward at kkenward@aha.org. The Institute and HRET are AHA affiliates.