Roll Call: Latest News on Capitol Hill, Congress, Politics and Elections
October 2, 2014

Posts in "Hospitals"

September 25, 2014

HHS Reports a Decline in Uncompensated Hospital Care

An objective of the health care overhaul’s provisions allowing states to expand coverage offered through the Medicaid program is the reduction in the burden on hospitals treating uninsured patients and the resulting hospital write-offs for uncompensated care. Hospitals are now beginning to recoup some the cost of treatment of previously uninsured patients through Medicaid, especially in states that have expanded the qualifications for Medicaid coverage.

The Department of Health and Human Services on Wednesday detailed the savings impact on hospitals, noting $4.2 billion in savings in states that have expanded the Medicaid program and $1.5 billion in states that have avoided an expansion. The federal government will pick up all of the expanded Medicaid program costs through 2016 and phase down to 90 percent of costs in 2020.

CQ HealthBeat’s (@CQHealthTweet) Rebecca Adams reported that the authors of the law expected a decline in charity care and bad debt as consumers gained insurance coverage. That was also one of reasons why Congress included in the health law billions of dollars in cuts in Medicare and Medicaid payments for hospitals that care for a large share of low-income patients. Additionally, the Affordable Care Act added requirements on charitable hospitals to document and justify policies and limit charges for uncompensated care.

 

 

 

 

 

September 19, 2014

Commission Examines Short Hospital Stay Payments

Congress needs lots of help in deciphering and analyzing Medicare provider payment policies and created an expert group – the Medicare Payment Advisory Commission – to advise on payment policy changes. A current major topic on Medicare payments relates to how hospitals are paid based upon the length of a hospital stay.

CQ HealthBeat’s (@CQHealthTweet) John Reichard reported this week that the Medicare payment commission is currently examining Medicare payment policy for single-day hospital stays.

Short inpatient stays, particularly for a single day, are one of the biggest money-makers for hospitals. Medicare currently pays hospitals a fixed sum for a particular diagnosis based on a calculation of costs that typically assumes a longer stay. However, Medicare auditors have targeted single-day stays in an effort to stamp out improper billing practices and the majority of Medicare claim denials in 2012 were for one-day stays.

Hospitals have taken steps to cut the risk of having their billings challenged and are increasingly classifying short-stay patients as being under “observational” status, which pays at lower outpatient rates.  However, patients listed in observational status must pay a 20 percent copay for outpatient treatment while they pay a fixed deductible for inpatient care of $1,200.

 

July 31, 2014

Medicare Payment Quirk Grabs Senate Panel’s Attention

Senators on Wednesday mulled the impact of a restriction in Medicare payment policies that has riled both hospitals and patients. When a Medicare patient stays in a hospital under “observation status” the person does not qualify for certain Medicare coverage in a subsequent stay in a nursing home or rehabilitation facility — and may end up paying more in co-payments and drug costs.

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By Paul Jenks Posted at 10:10 a.m.
Hospitals, Medicare

July 14, 2014

It’s July, So Here’s Another Article on ‘the July Effect’

Vox.com pronounces that “The July effect is real: new doctors really do make hospitals more dangerous” in an article posted yesterday. As the site points out, the term “is shorthand for the supposed spike in medical mistakes at hospitals during the month of July — right when millions of medical residents start new jobs.”

Other publications have taken a crack at the topic in recent years; perhaps surprisingly, they’re not all from July. They sometimes cluster around a release of a study:

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