AHA recommends changes to proposed rules for charitable hospitals   06/27/2013
AHA today recommended changes and clarifications to the Internal Revenue Service’s proposed rules for Community Health Needs Assessments and sanctions for noncompliance with the Patient Protection and Affordable Care Act requirements for tax-exempt hospitals, which would further relieve hospitals of unnecessary burden and provide greater certainty regarding enforcement. Under Section 501(r)(3) of the ACA, hospitals must assess community health needs at least once every three years and adopt a strategy to address them. While the proposed rule makes important improvements to the IRS’ 2011 guidance on CHNAs to reduce the burden on hospitals, satisfying the proposed requirements could still take thousands of hours and cost tens of thousands of dollars or more, AHA said in comments submitted to the agency. To further ease the burden on hospitals, AHA recommends removing, changing or clarifying certain requirements for the CHNA and implementation strategy. AHA said it welcomes the proposed rule’s recognition that loss of exemption should occur only in extreme circumstances, but recommended modifications and clarifications to advise hospitals more clearly on how the statute will be enforced. AHA also requested more time to comply with certain other requirements that impact hospital policies, procedures and information systems. In addition, AHA urged the agency to specify whether the rules applies to government hospitals and if so, how.
Chamber recommends changes to increase health care value   06/27/2013
The U.S. Chamber’s Health Care Solutions Council today issued a report suggesting ways to reduce variation in health care cost, quality and access by building on employer-based initiatives. The report proposes regulatory and legislative changes to facilitate and reward better coordination among health care providers; define quality simply and clearly so that providers understand the metrics by which they will be measured; remove barriers to easily understandable and comparable information on the cost and quality of health care services; encourage consumers to use this information to make health care decisions; protect the ability to buy or offer affordable health care coverage; and apply lessons from private-sector reforms to improve Medicare and Medicaid. Among other proposals, the report recommends continuing Medicaid Disproportionate Share Hospital payments in states that do not expand Medicaid coverage, and eliminating reliance on Medicare provider payment reductions to meet short-term budget goals.
Study: Cost of hospital care for high-cost Medicare patients rarely preventable   06/27/2013
Only a small percentage of costs for patients in the top portion of Medicare spending appear to be related to preventable emergency department visits and hospitalizations, according to a study in this week’s Journal of the American Medical Association. The study looked at potentially preventable ED visits and hospitalizations among a sample of patients in the top decile of Medicare spending in 2009. Only 10% of these patients had acute-care costs that were considered preventable. “The biggest drivers of inpatient spending for high-cost patients were catastrophic events such as sepsis, stroke, and myocardial infarction, as well as cancer and expensive orthopedic procedures such as spine surgery and hip replacement,” the authors said. “These findings suggest that strategies focused on enhanced outpatient management of chronic disease, while critically important, may not be focused on the biggest and most expensive problems plaguing Medicare’s high-cost patients.”