CMS to host Nov. 21 call on LTCH quality reporting program   11/08/2013
The AHA and American Medical Association today urged the Centers for Medicare & Medicaid Services to delay enforcement of its two-midnight policy for inpatient admission and review criteria until October 2014, and convene a meeting with affected stakeholders to develop alternate policy solutions. “The fundamentally flawed, overly complicated two-midnight policy does not provide the clarity needed for consistent decision-making by either providers or reviewers,” the groups wrote. “…Moreover, it has been impossible for hospitals and physicians to come into compliance with the two-midnight policy given the two-month time period between the release of the final rule and the policy’s effective date. Even with the partial delay in enforcement through March 31, 2014, there is not enough time for hospitals and physicians to adjust.” In particular, hospitals need additional time to reevaluate and potentially change many internal policies, update existing electronic medical records systems, and alter work flow processes to ensure compliance with the two-midnight policy, the letter notes. “Physicians will need extensive education on the two-midnight policy and time to adapt to its order and certification requirements, many of which are still unclear,” they add.  
HHS issues final mental health parity rule   11/08/2013
The departments of Health and Human Services, Labor and the Treasury today issued a final rule requiring large group health plans that provide mental health or substance use disorder benefits to provide them on a par with their medical/surgical benefits, as required by the Mental Health Parity and Addiction Equity Act of 2008. Effective 60 days after publication in the Nov. 13 Federal Register, the rule will apply for plan years beginning on or after July 1, 2014. Financial requirements (such as deductibles and co-payments) and treatment limitations (such as number of visits and days of coverage) that apply to MH/SUD benefits must be no more restrictive than the predominant requirements and limitations that apply to substantially all medical/surgical benefits. In addition to inpatient, outpatient and emergency care, the rule applies to intermediate levels of care such as partial hospitalization services, and eliminates an interim final rule provision that allowed insurance companies to make an exception to parity requirements for certain benefits based on “clinically appropriate standards of care.” For more information, see the HHS factsheet and FAQ. “America’s hospitals are pleased that the Administration has issued the final rule implementing the Mental Health Parity and Addiction Equity Act,” said AHA Executive Vice President Rick Pollack. “While we are still reviewing the rule, it is an important step toward removing barriers to care that affect many patients suffering from psychiatric and substance abuse conditions.” AHA will provide additional details to members soon. 
MedPAC discusses post-acute issues   11/08/2013
The Medicare Payment Advisory Commission yesterday discussed potential payment reforms for post-acute care. One session reviewed prior MedPAC research that would eliminate the Long-Term Care Hospital Prospective Payment System and pay LTCHs through far lower inpatient PPS payments. Commissioners also reviewed concurrent LTCH research by the Centers for Medicare & Medicaid Services that would maintain the LTCH PPS but drastically reduce the patient population that would remain eligible for LTCH-level payments. The AHA strongly opposes both approaches, neither of which has been formally proposed, as they would exclude a significant volume of LTCH-appropriate patients from LTCH-level payment. Another session yesterday sketched out a preliminary site-neutral payment framework for inpatient rehabilitation and skilled nursing cases involving major joint replacement, hip fracture and stroke. The commission plans to continue its research and provide an update on these topics in 2014.
AHA white paper examines bedside care team of the future   11/08/2013
A new AHA white paper examines the role of bedside care teams in a changing health care system. “The changes confronting the health care system are so significant that many of the models that the health care system has relied on, such as the traditional bedside care team, may no longer be the best, or even a plausible, approach to care,” according to the paper, which summarizes the findings of an AHA-convened roundtable on the issue. Participants identified six principles that will characterize movements toward a reconfigured bedside care team during the next five years; foundational concepts that must be in place for this work to occur; cutting edge practices; and examples of hospitals that have innovative and engaged bedside care teams.
Resource helps hospitals make case for equity in care   11/08/2013
A new resource from the Equity of Care initiative and AHA’s Hospitals in Pursuit of Excellence provides strategies hospitals can use to address health care disparities and highlights the business imperative for providing equity in care. Launched in 2011 by the AHA, Association of American Medical Colleges, American College of Healthcare Executives, Catholic Health Association of the United States, and America’s Essential Hospitals, Equity of Care is a national call to action to eliminate health care disparities by increasing diversity in health care governance and leadership; cultural competency training; and collection and use of race, ethnicity and language preference data. This resource is part of a series of free tools and shared best practices available on the Equity of Care website.
Hospitals add 2,200 jobs in October   11/08/2013
Employment at the nation's hospitals rose by 0.05% in October to a seasonally adjusted 4,836,400 people, the Bureau of Labor Statistics reported today. That's 2,200 more people than in September and 25,200 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, hospitals employed 4,837,000 people in October – 8,000 more than in September and 25,200 more than a year ago. The nation's overall unemployment rate rose by 0.1 percentage point in October to 7.3%.