HRSA issues final rule for 340B orphan drug exclusion   07/23/2013
The Health Resources and Services Administration today published a final rule clarifying how it will implement the exclusion of orphan drugs under the 340B drug discount program for hospitals and rural referral centers newly eligible for the program under the Patient Protection and Affordable Care Act. The ACA expands eligible participants in the 340B program to include critical access hospitals and certain non-prospective payment system children's hospitals, free-standing non-PPS cancer hospitals, and sole community hospitals and rural referral centers that have disproportionate share adjustment percentages equal to or greater than 8%. According to HRSA, the rule “will provide clarity in the marketplace, maintain 340B savings for newly-eligible covered entities, and protect the financial incentives for manufacturing orphan drugs designated for a rare disease or condition as indicated in the Affordable Care Act and intended by Congress.” Like the proposed rule, the final rule allows these newly covered entities to purchase outpatient orphan drugs at 340B prices to treat common conditions for which the drugs are approved, but not to treat the rare conditions or diseases for which the drugs were given their orphan drug designation. For more information, see HRSA’s Frequently Asked Questions about the rule. AHA members who are 340B participants will receive a Special Bulletin with further details.
House subcommittee approves physician payment reform bill   07/23/2013
The House Energy and Commerce Health Subcommittee today approved by voice vote bipartisan legislation that would reform Medicare’s sustainable growth rate formula for physician payment. The legislation, which does not specify a funding source, would replace the SGR with an annual update of 0.5%. Beginning in 2019, physicians practicing in fee for service also would receive a 1% bonus or payment reduction based on performance on quality measures and clinical practice improvement. Those who fail to report quality information would continue to receive a payment reduction under the Physician Quality Reporting Program. The legislation also directs Medicare to identify improperly valued services under the physician fee schedule, which would result in a net reduction of 1% of the projected amount of expenditures during 2016 through 2018. Among other changes, the legislation would pay for care coordination services by certain qualified physicians and create a new avenue for developing and testing alternative payment models.
Programs honored for innovation in palliative, end-of-life care   07/23/2013
Three programs that expand the reach of palliative and end-of-life care will receive 2013 Circle of Life awards Friday at the Health Forum and AHA Leadership Summit in San Diego. The programs, which serve as innovative models for other communities, are: Denver Hospice and Optio Health Services in Colorado; Mount Sinai Medical Center in New York; and the UnityPoint Health Palliative Care Program in Iowa and Illinois. “This year’s Circle of Life honorees exemplify the best in health care – providing compassionate care and helping patients and families facing complex health challenges,” said AHA President and CEO Rich Umbdenstock. Citations of honor will go to: Gundersen Health System in La Crosse, WI; Hospice of Dayton in Ohio; Nathan Adelson Hospice in Las Vegas; North Shore University Hospital Palliative Care Program in Manhasset, NY; and the Veterans Health Administration in Washington, D.C. For more on the programs, see the AHA news release.
Guide helps CA hospitals enroll uninsured in health coverage   07/23/2013
A new guide from the California Hospital Association provides information and strategies to help hospitals enroll uninsured patients in health coverage, including the new Health Insurance Marketplace or exchanges beginning in October under the Patient Protection and Affordable Care Act. The guide details eight proven hospital-based outreach and enrollment strategies, such as positioning trained staff at critical access points. “Hospitals will continue to be one door through which the uninsured will pass,” said CHA Senior Vice President of Health Policy Anne McLeod. “The shared goal of the ‘no-wrong-door’ approach will enable hospitals to easily and effectively help these individuals obtain health care coverage.” AHA contributed funding for the guide.
Georgia health systems announce regional alliance   07/23/2013
Hospital and health system CEOs in central and south Georgia today announced a partnership “to enhance the health and wellness of residents in their communities by improving the regional coordination of medical services for patients, employers and payers.” Officials said the alliance of 23 hospitals and about 1,500 physicians, called Stratus Healthcare, will work to exchange best practices, combine resources, develop coordinated information systems, reduce costs and manage the health of populations. Member hospitals will take advantage of a shared services model, yet remain independent. Central Georgia Health System in Macon and Tift Regional Health System in Tifton began forming the group last April. “Each Stratus partner wants to add value for patients and create scale, yet realizes it could be accomplished much easier through a coordinated effort with other health care organizations,” said William Richardson, president and CEO of Tift Regional Health System.