May 16, 2019 | Hospitals, Inpatient, LTCHs
CMS has released the 2020 proposed rule for the hospital inpatient (IPPS) and the long-term care hospital (LTCH) payment systems. CMS estimates a 3.5% increase to IPPS payments and a 0.9% increase to LTCH payments in 2020. Additionally, CMS has proposed changes to the hospital wage index to decrease disparities between states. Click to read more.
May 15, 2019 | Medicaid, Medicare, Payers
The dual eligible population is generally medically complex, and thus has historically accounted for a disproportionately large share of expenditures in both the Medicare and Medicaid programs. Lack of alignment between the programs can be costly and result in fragmented care. In an effort to better integrate care for duals, CMS discusses in a recent letter to State Medicaid Directors three opportunities: the capitated financial alignment model, managed fee-for-service model, and state-specific models. Click to read more.
May 13, 2019 | Drugs, Medicare Advantage, MedPAC, Part D, Payers, Post-Acute Care, Products
MedPAC’s April meeting covered topics related to value-based payment, shared savings, Medicare Advantage star ratings and encounter data, emergency department spending growth, Part D specialty drugs, post-acute care assessments, and dialysis. The Commissioners voted on draft recommendations, including that CMS should establish national coding guidelines for emergency departments. Click to read more.
May 8, 2019 | Inpatient Rehab (IRF)
CMS recently released its annual proposed rule for Inpatient Rehabilitation Facilities (IRF), which reflects a continuing trend of stability in the space overall. However, CMS estimates its proposed changes to case mix calculations and other changes would result in a less positive overall impact for some for-profit providers. Click to read more.
May 7, 2019 | Legislation/ Budgets/ Macro, Medicare, Payers
CBO released a report on policy details that legislators must consider in designing a single payer health care system that attempts to achieve universal coverage. The budget office did not estimate the cost impact of a new health care system, in part reflecting the lack of consensus around a specific proposal. We continue to believe that a true single payer system is not politically feasible, even under an all Democratic government. It’s possible that the proposals coalesce around a more moderate approach to expand the government’s role in paying for health care, alongside private insurers,...
