Even if the Supreme Court overturned the Affordable Care Act, hospitals would still experience huge cuts in Medicare payment, and there would still be a movement away from traditional fee-for-service, said Marian Jennings at the recent iProtean Symposium in La Jolla, California. “We have put a lot of things into the bucket called “healthcare […]
Two pay-for-performance programs in the Affordable Care Act became effective on Monday—one relating to value-based purchasing and another targeting readmission rates. Both programs enable Medicare to reward hospitals for providing more efficient and higher quality care and penalize those hospitals that don’t measure up. Under the value-based purchasing program, Medicare will pay hospitals based […]
Hospitals that serve a large number of patients who have little or no funds to cover the costs of care, Medicaid patients and Medicare patients on disability have relied on a “disproportionate share” payment from CMS. The Affordable Care Act (ACA) added new provisions to the formula for calculating this payment to hospitals. The recent […]
Under payment reform in the Accountable Care Act (ACA), accountable care organizations (ACO) will receive incentives that reward efficiency and quality care. For the time being, ACOs will be paid based on DRGs, although it is expected there will be elements of capitation involved in the future. However, when determining how the ACO will […]
Moody’s Investor Service recently released an update of its 2012 outlook for not-for-profit hospitals, noting that the negative outlook remains but emphasizing both established risks and developing trends that have become more prominent over the last nine months. (Not-for-Profit Healthcare Mid-Year 2012 Outlook: Strong Headwinds Continue, Moody’s Investors Service, August 2012.) According to the […]
Atul Gawande, M.D., celebrated for his thoughtful article about the quality of care in U.S. hospitals/systems, recently wrote that “the way medical care is organized Is changing—because the way we pay for it is changing.” (Atul Gawande, “Big Med,” The New Yorker, August 13, 2013) The goal of many large health systems, Dr. Gawande […]
“There is no deadline for a state to tell our Department [CMS] its plans on Medicaid eligibility expansion,” said Marilyn Tavenner, acting administrator for CMS in a letter to the Republican Governors Association last week. Tavenner’s letter to the Republican Governors Association was in response to questions stemming from the U.S. Supreme Court’s recent […]
U.S. Department of Health and Human Services Secretary Kathleen Sebelius last week announced the approval of 89 new Accountable Care Organizations (ACOs) for participation in the Medicare Shared Savings Program (MSSP). The 89 ACOs will serve Medicare beneficiaries in forty states and Washington, DC. This brings the total number of ACOs to 154, including the […]
Last week the Supreme Court ruled that the Patient Protection and Affordable Care Act (ACA) is constitutional. The ruling should reduce some uncertainty among hospitals as they plan for the structural reforms in the law. But the ruling on Medicaid expansion, allowing states to opt out, may put hospitals in some states at risk for […]
iProtean—Bond Financing Part 2 Balance sheet strength remains an imperative for hospitals and health systems today, but is a significant challenge as organizations transition to a new business model. A recent report from Moody’s Investors Service noted that nearly all of its rated hospitals cited the need to build balance sheet reserves as a […]