White House proposes more than $400 billion in Medicare, Medicaid reductions   03/04/2014
President Obama today released a fiscal year 2015 budget request that includes $407 billion in proposed reductions to Medicare, of which $354 billion would come from health care providers, and $7.3 billion in reductions to Medicaid. “Today’s budget proposal includes some problematic policies that would undermine the ability of hospitals to improve the health care system and, ultimately, puts access to services at risk for the patients and communities we serve,” said AHA President and CEO Rich Umbdenstock. The budget proposal would reduce bad debt payments to providers, including hospitals, by $30.8 billion; Medicare graduate medical education payments by $14.6 billion; and critical access hospital payments from 101% to 100% of reasonable costs, among other cuts. AHA members received a Special Bulletin with further details. Later this afternoon, the Department of Health and Human Services provided more details on the president’s FY 2015 discretionary budget request. Children’s Hospitals Graduate Medical Education funding would be eliminated, down from its current level of $265 million; however, it would receive $100 million funded by Medicare GME cuts. Other provisions include $4 million to fund a new Rural Physician Training grant program; $17 million for the 340B drug pricing program to help improve the program’s operations and oversight; $57 million for Rural Health Outreach grants; $26 million for Rural Hospital Flexibility grants, a reduction of $14 million from FY 2014 funding; and $14 million to support the Health Resources and Services Administration’s efforts to expand health technology systems. In addition, it would provide $255 million for the Hospital Preparedness Program, the same amount as FY 2014, and $144 million to develop nursing workforce programs.
Study: Structural changes could save Medicare additional $900 billion   03/04/2014
The Medicare program could save an additional $900 billion over the next 10 years due to structural changes throughout the health care sector that are driving spending down, according to a new report by health care economics consulting firm DobsonDaVanzo, released today by the Federation of American Hospitals. New evidence of a spending slowdown include projected health care spending growth of 3.8% for 2013, the fourth consecutive year of historically low growth; a decline in Medicare hospital spending per beneficiary to 0.3% in 2012 from 6% in 2009; and near record-low health care and hospital price growth over the past year of 1.1% and 1.5%, respectively, the authors said. According to the report, structural changes driving the spending slowdown include a shift to value-based payments and declines in hospital readmission rates and healthcare-associated infections, among other trends.
CDC issues antibiotic stewardship tools for hospitals   03/04/2014
The Centers for Disease Control and Prevention today issued new tools to help hospitals develop antibiotic stewardship programs to improve prescribing practices, with the goal of protecting patients from preventable complications and reducing the emergence of resistant organisms such as C. difficile that lead to serious life-threatening infections. The tools include a checklist and guidance for implementing a stewardship program that dedicates the necessary human, financial and information technology resources; appoints a single leader responsible for program outcomes and a single pharmacist leader to support improved prescribing; takes at least one prescribing improvement action; tracks and regularly reports to clinicians on prescribing and antibiotic resistance patterns; and offers education on how to improve them. According to a CDC Vital Signs report released today, physicians in some hospitals prescribe three times as many antibiotics as their colleagues in other hospitals, suggesting the potential to improve prescribing practices in certain clinical scenarios. According to the report, a 30% reduction in the antibiotics most likely to cause C. difficile infections could reduce these infections by more than 25%. AHA Senior Vice President John Combes, M.D., who participated in a CDC briefing today on the report, noted that AHA recently addressed this issue in its white paper on “Appropriate Use of Medical Resources,” which recommends that hospitals maintain an antibiotic stewardship program along with four other interventions to reduce non-beneficial medical services. A toolkit for the development of an antibiotic stewardship program, including the new CDC resources, will be available to hospitals in the coming months.