CMS issues proposed hospice payment update for FY 2014   04/30/2013
Hospices would see a 1.1% ($180 million) increase in Medicare payments in fiscal year 2014 under a proposed rule issued yesterday by the Centers for Medicare & Medicaid Services. The net increase is based on a 2.5% increase in the inpatient hospital marketbasket (the proxy for hospices) minus 0.7 percentage point for reductions required by law; a 0.6% decrease as part of the agency's seven-year phase-out of the wage index's budget neutrality adjustment factor; and a 0.1% decrease due to the use of updated wage data. In addition, hospices that fail to meet quality reporting requirements would receive a 2 percentage point reduction to their marketbasket update under the ACA. The ACA also requires CMS to reform the hospice payment system sometime after FY 2013. The proposed rule discusses reform model options, as well as CMS efforts to develop a hospice experience of care survey for informal caregivers. CMS also clarifies that hospice providers should not use certain diagnoses on hospice claims and seeks additional comments on appropriate diagnosis coding. The rule will be published in the May 10 Federal Register with a 60-day comment period.
CMS simplifies insurance applications for new marketplace   04/30/2013
The Centers for Medicare & Medicaid Services has simplified and shortened the applications for individuals and families who apply for health coverage through the Health Insurance Marketplace beginning in October. Consumers will be able to apply online, by phone or paper. The paper application for individuals without health insurance was reduced to three pages from 21, while the application for families was reduced by two-thirds, CMS said. The online version of the application will be a dynamic experience that shortens the application process based on individuals’ responses.
Hoyer calls for 'big and balanced' fiscal agreement   04/30/2013
Congress should strive to reach a “big and balanced” agreement to address the nation’s fiscal debt and deficit, House Minority Whip Steny Hoyer (D-MD) told hospital leaders today at the AHA Annual Membership Meeting in Washington, D.C. Hoyer called for a bipartisan compromise but said “any future changes to entitlement programs, and to Medicare in particular, must be made with an understanding of and in concert with reforms we enacted in the Affordable Care Act.” He praised hospital efforts that have led to significant reductions in readmissions, better care coordination and slower Medicare spending, and said the next few months would be critical to implementing ACA provisions. “When they are fully implemented and made operational, I anticipate that we will continue to see improvements in quality and efficiency that make the care you deliver not only better, but also importantly, more cost effective,” Hoyer said.
Burgess: States could present ACA roll-out challenges   04/30/2013
Hospitals should prepare themselves for what could be a bumpy rollout of the Patient Protection and Affordable Care Act in the fiscal year beginning Oct. 1, House Energy and Commerce Committee member Michael Burgess, M.D., (R-TX) told hospital leaders today at the AHA Annual Membership Meeting. He said major challenges include getting reluctant states to set up health insurance exchanges and expand their Medicaid programs. “You will have to deal with the bumps and burps in the system,” Burgess says. “You will bear the effect of any policy that is decided at the state level.” The congressman also noted that the president’s recent budget request for the next fiscal year calls for a one-year delay in payment cuts to Medicaid disproportionate share hospitals, because fewer people now are expected to be insured under the ACA. “We will see where that all sorts out and how we can help you with that,” he told AHA members.
Former White House advisor shares federal budget advice   04/30/2013
Medicare can’t be sustained over the long haul without a mix of revenue increases and structural changes to the program, Steve Rattner, a journalist and former economic counselor to the Obama administration, told hospital leaders today at the AHA Annual Membership Meeting. However, he’s not optimistic that will happen. “I just don’t see a lot of signs of Washington getting anything done,” he said. On the revenue-raising side of the equation, Rattner recommends eliminating some or all of the remaining Bush-era tax cuts, reforming the tax code to remove loopholes and enacting a sales or consumption tax. He said those changes should be complemented by cuts to “unnecessary” defense spending and elimination of wasteful programs like agricultural subsidies. He also proposes changes to Medicare that include raising the eligibility age to 67, imposing means testing and higher premiums for wealthy seniors, requiring higher co-payments for all beneficiaries and enacting comprehensive medical liability reform.
Panel discusses Enroll America efforts   04/30/2013
Health care leaders today discussed opportunities and challenges to enroll uninsured people in health coverage beginning Oct. 1 under the Patient Protection and Affordable Care Act during a special AHA members-only Town Hall Interactive webcast held in conjunction with the AHA’s Annual Membership Meeting. Moderated by AHA President and CEO Rich Umbdenstock, the panel focused on efforts under way through Enroll America – a non-profit organization working to enroll uninsured people in health coverage. “It will be critical in our view that hospitals train their staff on how to answer basic coverage questions and how to provide effective referrals to enrollment assistors in their community,” said Anne Filipic, president of Enroll America. Mary Grealy, president of Healthcare Leadership Council, shared successful strategies from previous national health enrollment efforts, and Cynthia Taueg, vice president of ambulatory and community health services at St. John Providence Health System in Warren, MI, described efforts at the health system to enroll uninsured individuals in coverage. The AHA is a member of Enroll America.
Center proposes framework for sustainable health care cost savings   04/30/2013
The Engelberg Center for Health Care Reform at The Brookings Institution yesterday proposed a framework for sustainable cost savings in the U.S. health care system, which the authors estimate would produce net federal savings of at least $300 billion over 10 years. Proposed reforms include Medicare Comprehensive Care organizations, integrated systems or networks of providers that would accept case-based or bundled payment for services and be required to meet certain performance standards for full payment. Medicaid would transition state waivers to a standard process and infrastructure for reforms, and expand and make permanent the Financial Alignment Demonstration for Medicare-Medicaid dual eligible beneficiaries. Other proposals include capping the tax exclusion for employer-sponsored health insurance, and reforms aimed at system-wide efficiency such as an updated standardized claim form. The bipartisan group of authors includes former Centers for Medicare & Medicaid Services Administrator Mark McClellan, the center’s director; former secretaries of Health and Human Services Michael Leavitt and Donna Shalala; former Senate Majority Leader Tom Daschle (D-SD), and former director of the White House Office of Management and Budget Peter Orszag.
Task force recommends HIV screening for all Americans aged 15-65   04/30/2013
The U.S. Preventive Services Task Force today finalized a recommendation calling for clinicians to screen all people aged 15 to 65 for HIV infection, including pregnant women, as well as younger and older people at increased risk for infection. The panel assigned an "A" grade to the recommendation, which means all copays and deductibles for the screenings would be waived under the Patient Protection and Affordable Care Act. The independent panel said the recommendation is aimed at helping infected people begin treatment earlier to reduce their risk for AIDS and spreading the infection. According to the Centers for Disease Control and Prevention, an estimated 1.2 million U.S. residents are infected with HIV, up to one-quarter of whom do not know it.