30-day readmission penalties may unfairly impact safety net hospitals because those facilities tend to care for more patients with socio-economic challenges, according to researchers and health policy analysts. Earlier this year, the National Quality Forum (NQF) issued a draft report where it noted: “failing to adjust performance measures for socio-demographic factors could produce incorrect […]
Traditionally, Medicare has required that its beneficiaries have at least three days in the hospital to qualify for follow-up nursing home care. The Centers for Medicare and Medicaid Services (CMS) is testing the effectiveness of that requirement by exempting patients at some hospitals participating in certain Affordable Care Act (ACA) pilot projects. These projects have […]
Hospitals may have some leeway with the controversial two-midnight rule. Buried in the Centers for Medicare and Medicaid (CMS) proposed rule to increase outpatient rates (reported here in last week’s newsletter blog) is a plan to alter the two-midnight inpatient admissions rule. The two-midnight rule requires physicians to document that they expect the patient must […]
With all the news about declining payments to hospitals, gratifying news surfaced last week: the Centers for Medicare and Medicaid Services (CMS) wants to raise Medicare outpatient payments to hospitals by 2.1 percent in 2015. Ambulatory surgery center payments would increase by 1.2 percent. The proposed increases are higher than those finalized by CMS for […]
A recent roundtable of policymakers and researchers in Washington D.C. exposed differing viewpoints about the competitive aspects of hospital consolidations. Because the impact of consolidation on competition and prices in a market continues to excite discussion and controversy, the participants called for regulators to approach their antitrust scrutiny from a different perspective. Some roundtable […]
The Affordable Care Act’s (ACA) Medicaid eligibility expansion provision has reduced charity care and self pay in hospitals in states that have adopted the provision, according to a new study by the Colorado Hospital Association’s Center for Health Information and Data Analytics. Authors of the study reviewed monthly financial and volume data for the […]
Moody’s Investors Service analysis of the 2013 not-for-profit preliminary medians shows “continuing operating pressures” in the industry. Operating margins and operating cash flow margins dropped as revenue growth continued to slow and expense growth continued to surpass revenue growth. Debt coverage metrics remained stable and balance sheet measures grew despite weaker operating performance. The […]
Hospital financial performance generally returned to pre-recession status by 2011, according to a report published in Health Affairs. The research examined financial performance of nearly 3,000 acute care hospitals from 2005 through 2011. “Hospitals that were strong financial performers before the recession remained strong during the study period, while hospitals that were financially weak […]
Hospitals have decreased the frequency of patient harm and readmissions over the last two years, according to a new report from the Centers for Medicare & Medicaid Services (CMS). Experts credit the new quality initiatives in the Affordable Care Act (ACA), but some patient safety improvements preceded that law. (“Hospitals Boost Patient Safety, But More […]
The Centers for Medicare & Medicaid Services (CMS) has proposed a 1.3 percent increase in payments to hospitals under the inpatient prospective payment system (IPPS) for 2015. However, it projects a decrease in overall payments of about $241 million, primarily because of payment reductions for readmissions and hospital acquired conditions (HAC). Provisions related to readmissions […]