Committee leaders propose standardized patient assessment data collection   03/19/2014
Leaders of the House Ways and Means and Senate Finance committees yesterday released draft legislation to implement consistent patient assessment requirements for hospitals and providers of post-acute care, including long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies. Specifically, the legislation would require post-acute providers, inpatient prospective payment system hospitals, critical access hospitals, non-PPS cancer hospitals and outpatient therapy providers to collect standardized data on patients’ clinical and functional status and Medicare spending and readmissions, primarily using existing assessment tools. The data would be collected on admission to the hospital and on admission and discharge from post-acute and outpatient therapy settings. To improve the discharge process, IPPS hospitals and post-acute providers also would face new Medicare conditions of participation related to hospital-to-post-acute discharge protocols. By the end of the bill’s eight-year timeline, the Department of Health and Human Services and the Medicare Payment Advisory Commission would develop alternative payment models for post-acute care that base payments on patient characteristics rather than care setting. The committee leaders said they plan to work with their colleagues and the health care community “to further improve the legislative draft, with the goal of formally introducing consensus legislation in the future.”
Congressman urges HHS to modify RAC program   03/19/2014
Rep. Jim McDermott (D-WA), ranking member of the House Ways and Means Health Subcommittee, yesterday urged the Department of Health and Human Services to require enhanced accountability for Medicare recovery audit contractors rather than implement its two-midnight policy for inpatient admissions and medical review criteria. “I continue to have serious reservations about this policy and believe that it will only exacerbate the appeals backlog,” he said in a letter to HHS Secretary Kathleen Sebelius. He added, “I suggest that there needs to be some financial penalty associated with RA collections that are overturned on appeal. If providers are winning these appeals by large margins, which seems to be the case, this seems only fair…I also suggest that going forward, the contracts include performance standards for accuracy of collections from providers.” AHA supports the Medicare Audit Improvement Act (H.R. 1250/S. 1012), a comprehensive bill for reforming the RAC program. The bill currently has 202 cosponsors in the House and 11 in the Senate. AHA also supports the Two-Midnight Rule Coordination and Improvement Act (S. 2082), legislation that would require CMS to implement a new payment methodology for short inpatient stays in FY 2015, and the Two-Midnight Rule Delay Act (H.R. 3698).
New report, website examine health care realignment trend   03/19/2014
Hospitals are deploying a variety of clinical and financial integration strategies that increase coordination across the care continuum, improve patient outcomes, reduce costs, enhance the availability of health care in underserved areas, and improve the care experience for patients and families, according to a new AHA TrendWatch report. “Even as regulatory barriers continue to constrain the pace of innovation, these efforts are expanding and are achieving promising results in terms of improving the patient care experience, quality and efficiency,” the report notes. AHA and the Federation of American Hospitals today launched a new website examining how market trends and features of the Affordable Care Act are driving a major realignment of the health care system to better serve patients and communities. To view the website, visit
CMS seeks applicants for Medicare hospice care model   03/19/2014
Hospices can apply through June 19 to participate in the Medicare Care Choices Model, which will test new models of care that offer select hospice services while allowing curative care to continue. The model will focus on Medicare patients and Medicare-eligible Medicaid patients with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS who meet hospice eligibility requirements. Currently, Medicare beneficiaries are required to forgo curative care to receive palliative care offered by hospices. The project will examine whether access to such services improves quality of care and patient and family satisfaction and any effects on the use of curative services and the Medicare hospice benefit. The hospices will provide services available under the Medicare hospice benefit for routine home care and inpatient respite levels of care that cannot be separately billed under Medicare Parts A, B and D. For more information, see the Centers for Medicare & Medicaid Services notice.
Monograph explores hospital boards role in philanthropic fundraising   03/19/2014
The latest monograph from the AHA’s Center for Healthcare Governance discusses the important role that philanthropy can play for hospitals and health systems, and how governing boards and foundation boards can work together to increase the impact of charitable giving on the organization’s mission. The report includes tools and resources to help boards define their role participating in and overseeing philanthropic activities, such as talking points for approaching potential donors and sample metrics for monitoring fund development goals, and provides context for boards as they consider how philanthropy can be a strategic resource to support the organization’s future priorities and goals. The Center is AHA’s resource for information, tools and counsel to promote excellence in health care governance.
Reminder: AHA survey on Probe & Educate audits due Friday   03/19/2014
AHA encourages all members to complete by March 21 a short survey on the Center for Medicare & Medicaid Services’ two-midnight policy and related Probe & Educate audit process. Emailed to members March 13, the survey will help determine whether Medicare Administrative Contractors are conducting the Probe & Educate audits consistent with standards set forth by CMS, and whether the audits will be completed by Sept. 30. Responses will help the association in its advocacy efforts on the two-midnight policy, including any issues or concerns with the Probe & Educate audits.