Report on hospital mergers, acquisitions shows benefits to communities   06/03/2013
Only 10% of community hospitals were involved in a merger or acquisition in the past six years, and those transactions have allowed hospitals to retain vital services that have clear benefits to patients and communities, according to a report released today by the AHA and the Center for Healthcare Economics and Policy. The report found that of the 551 hospitals that were involved in a merger or acquisition, the vast majority involved expansion into new areas or occurred in areas where there were more than five hospitals. At a press briefing on the report, AHA Executive Vice President Rick Pollack said the need to improve quality and increase efficiency is creating realignment in the health care system. “One of the key elements in this transformation are hospitals that are strengthening ties to each other and hospitals that are strengthening ties to physicians in an effort to provide coordinated care across the whole health care continuum,“ Pollack said. At the briefing, Jerry Morasko, president and CEO of Avita Health System in Galion, OH, described how the acquisition of Bucyrus Community Hospital helped save more than 250 jobs, increased technological efficiencies and allowed the system to recruit more specialists to expand access to care in the rural area.
AHA participates in White House conference on mental health   06/03/2013
President Obama and Vice President Biden today hosted a National Conference on Mental Health at the White House as part of an effort to “launch a national conversation to increase understanding and awareness about mental health.” Conference participants included AHA President and CEO Rich Umbdenstock and Paul Summergrad, M.D., chair of the AHA’s Section Council for Psychiatric and Substance Abuse Services and psychiatrist-in-chief at Tufts Medical Center, who shared information on creative steps hospitals are taking to increase awareness and improve access to mental health services. Umbdenstock also encouraged AHA members to raise awareness of mental health in their communities, and said “adequate support from Medicare and Medicaid is essential if hospitals are to continue offering the array of services their communities have come to expect and depend on.” Umbdenstock also stressed the importance of the Mental Health Parity and Addiction Equity Act, noting, “A final rule is needed to prevent health plans from applying pre-authorization requirements to mental health and substance abuse benefits, among other issues.” As part of the White House initiative, the Department of Veterans Affairs plans to convene local mental health summits with community partners to help address the needs of veterans and their families. The administration also announced a new consumer website,, offering tools and information on mental illness and how to get help if needed.
CMS releases Medicare data on outpatient charges, county-level spending   06/03/2013
The Centers for Medicare & Medicaid Services today released selected Medicare data on hospital outpatient charges, and county-level data on Medicare spending and use of health care services. The outpatient data includes estimated hospital-specific charges and Medicare payments for 30 Ambulatory Payment Classification groups paid under the Medicare outpatient prospective payment system for calendar year 2011. The county-level data includes aggregated data on the prevalence of chronic conditions among Medicare beneficiaries, and Medicare spending and use for beneficiaries with multiple chronic conditions. “The release of new outpatient charge data by the Centers for Medicare & Medicaid Services is yet another step forward in transparency,” said AHA President and CEO Rich Umbdenstock, noting that what hospitals charge and what they are paid are two very different things. “In fact, Medicare currently pays only 89 cents for every dollar hospitals spend treating outpatient beneficiaries.”
CAQH updates code combinations for ACA administrative simplification rules   06/03/2013
The Council for Affordable and Quality Healthcare has released updated code combinations for its CORE 360 rule, part of the operating rules for electronic transfer of health care funds and remittance advice under the Health Insurance Portability and Accountability Act. The 360 rule refers to the code combinations for using claim adjustment reason codes and remittance advice remark codes. Under the Patient Protection and Affordable Care Act, health plans and other HIPAA-covered entities, including hospitals, must comply with the operating rules by Jan. 1, 2014.