Senate budget resolution clears committee   03/15/2013
The Senate Budget Committee last night voted 12-10 along party lines to approve its budget resolution for fiscal year 2014, which is expected to move to the Senate floor next week. The budget plan would replace sequester cuts with $1.85 trillion in savings over 10 years through an equal combination of tax revenue increases and spending cuts. The cuts include $275 billion in unspecified health care reductions, aimed at “further realigning incentives throughout the system, cutting waste and fraud, and seeking greater engagement across the health care system.” The House budget resolution, reported out of committee Wednesday and expected on the floor next week, would reduce spending by more than $4.6 trillion over 10 years. About $2.7 trillion would come from health care, largely by repealing the Patient Protection and Affordable Care Act’s coverage provisions while maintaining the ACA’s reductions. The House plan also would transition Medicare to a premium support program, convert Medicaid to a block grant program and reduce federal Medicaid spending by $756 billion over 10 years, among other provisions.
House passes bill to streamline workforce training programs   03/15/2013
The U.S. House of Representatives today voted 215-202 to approve the Supporting Knowledge and Investing in Lifelong Skills (SKILLS) Act (H.R. 803), AHA-supported legislation that would promote a coordinated approach to workforce training programs. The bill would streamline and improve workforce development programs, create a single Workforce Investment Fund to augment state workforce initiatives, and eliminate unnecessary bureaucracy to make it easier for workforce development activities to be tailored to local needs. “Without decisive intervention, workforce shortages threaten hospitals’ ability to care for patients and communities,” AHA and its American Society for Healthcare Human Resources Administration said in a letter of support for the bill. “The provisions of the SKILLS Act will help meet this need.” The AHA’s American Organization of Nurse Executives subsidiary also sent a letter of support for the bill.
Bill would add Medicare-supported residency positions   03/15/2013
Sens. Bill Nelson (D-FL), Charles Schumer (D-NY) and Harry Reid (D-NV) yesterday reintroduced AHA-supported legislation (S. 577) that would add roughly 15,000 Medicare-supported positions to residency training positions. Preference for the additional positions, a 15% increase, would go to programs training physicians for primary care and general surgery. If a hospital closes, the bill would allow its residency positions to be redistributed to nearby hospitals. The bill also would give hospitals more flexibility to train residents in clinical settings outside the hospital, such as community health centers and physician offices. The Balanced Budget Act of 1997 froze the number of residency positions at the 1996 level. However, several studies have projected a substantial physician shortage in the coming years.
CMS notifying hospitals of annual payment update reduction   03/15/2013
The Centers for Medicare & Medicaid Services today began mailing notices to hospitals participating in the Inpatient Quality Reporting program that may be subject to a reduction in their annual payment update for fiscal year 2014. These hospitals may receive a payment reduction due to incomplete data for the IQR’s process-of-care and healthcare-associated infection measures. CMS encourages affected hospitals to submit a reconsideration request, which is due 30 days after the date on the notification letter. AHA will work with CMS to ensure affected hospitals know the process for submitting a reconsideration. Given that IQR eligibility is also required for participation in value-based purchasing, affected hospitals should strongly consider submitting a reconsideration request.
MedPAC issues March report to Congress   03/15/2013
The Medicare Payment Advisory Commission today issued its March report to Congress, which details fee-for-service payment recommendations for 2014 approved by the commission in January. The recommendations call for a 1% increase in hospital inpatient and outpatient prospective payment system payments. For inpatient services, MedPAC recommends that CMS use the difference between the 2014 statutory update and the recommended 1% increase to offset the costs of changes in hospitals’ documentation and coding. The commission recommends no marketbasket update for inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities or home health providers in 2014. MedPAC also restates its prior recommendation for a two-year rebasing of the HH payment system starting in 2013, rather than the four-year rebasing starting in 2014 mandated by the Patient Protection and Affordable Care Act. In addition, the commission recommends rebasing the SNF prospective payment system to better align payments with costs, which would result in an estimated 4% payment reduction in the first year. The report also calls for eliminating the update for ambulatory surgical centers in 2014 and requiring them to submit cost data, and for no increase in the outpatient dialysis bundled payment rate.
More annual Match Day students choose primary care residencies   03/15/2013
More medical school seniors are choosing residencies in primary care, according to results released today from the National Resident Matching Program. The number of U.S. students choosing primary care – internal medicine, family medicine, and pediatrics – rose by almost 400 during this year’s annual Match Day. A total of 17,487 graduating seniors participated in the event, the largest to date with more than 40,000 registrants, including 1,000 more seniors from the U.S. “We attribute the rising number of U.S. students to three new medical schools graduating their first classes as well as enrollment expansions in existing medical schools,” said NRMP Executive Director Mona Signer. The total number of positions offered in the Match was 29,171, an increase of 2,399 over last year and an all-time high. “The significant increase in positions was due to a change in NRMP policy that requires Match-participating programs to register and attempt to fill all positions in The Match,” Signer said.