CBO releases new report describing budgetary impact of the ACA
Posted by Nikki Hurt on May 15, 2013
The Congressional Budget Office (CBO), in conjunction with the Joint Committee on Taxation (JCT), issued updated budget projections for fiscal years 2014-2023, which include updated impact estimates of the insurance provisions in the Affordable Care Act (ACA). Slower than anticipated growth in health care spending, particularly in programs such as Medicare and Medicaid, is one of several factors that influenced the revised estimates…
CMS releases data on hospital charges
Posted by Nikki Hurt on May 8, 2013
In an effort to increase health care affordability and transparency, the Centers for Medicare and Medicaid Services (CMS) published data pertaining to hospital charges for the 100 most common services provided during Medicare inpatient stays. With more than 163,000 entries, the data released by CMS indicated wide variation in costs, both across the country and within similar regions. For instance, a joint replacement procedure can cost $5,300 in Ada, Oklahoma, while a similar procedure may cost upwards of $223,000 in Monterey Park, California. Similarly, heart failure treatments can cost anywhere between $9,000 and $51,000 in Jackson, Mississippi. To further promote the spirit of the Affordable Care Act (ACA), the US Department of Health and Human Services (HHS) will also be offering grants for entities to collect and analyze medical pricing and reimbursement data to aid consumers in their health care decision-making and promoting cost-effective care.
Brookings proposes reforms to save hundreds of billions in health care
Posted by Nikki Hurt on April 30, 2013
The Brookings Institution recently released a study that indicates how value-based payments and small, conscientious quality improvements to both the private and public insurance sectors can significantly reduce health care costs in the future. Bending the Cure: Person-Centered Health Care Reform, describes how such changes could save the federal government $300 billion over the next 10 years and more than $1 trillion over the next 20 years. Brookings finds that moving to patient-centered care is the ultimate means by which future cost savings can be achieved. For a specific example, the study proposes that Medicare should move away from the fee-for-service model and embrace comprehensive payment organizations.
CMS releases annual hospital IPPS rule
Posted by Nikki Hurt on April 29, 2013
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule of more than 1400 pages describing the new Medicare payment schedule for 2014. The annual Acute Care Hospital Inpatient Prospective Payment System (IPPS) rule proposes that general acute-care hospitals will see a payment increase of 0.8% and long-term care hospitals will see their payments rise by 1.1%. Pursuant to the Affordable Care Act (ACA), the NRPM also details the new penalty program for hospitals that do not reduce nosocomial infections, adding hip and knee implants and chronic obstructive pulmonary disorder to the 30 day readmission penalty program. Another component of the proposed rule alters Medicare disproportionate share hospital (DSH) payments. Additional payments to each hospital will be made based upon its percentage of the total uncompensated care rendered at all DSH hospitals at a given time, ultimately reducing overall DSH payments by 0.9%. Furthermore, hospitals that do not participate in the Hospital Inpatient Quality Reporting (IQR) Program will be subject to additional penalties.
Comments will be due by June 25th, 2013.
GAO report finds ACA cost controls not enough to account for increased spending
Posted by Michal McDowell on February 27, 2013
The Government Accountability Office (GAO) yesterday released a report on the long-term costs of the Affordable Care Act (ACA). The report found that the long-term fiscal outlook depends largely on whether elements in the ACA designed to control cost growth are sustained. As federal health care spending is expected to continue growing faster than the economy over the next 75 years, the federal budget is on an unsustainable path, even with ACA measures intended to curb cost growth. Yesterday, at a Senate Budget Committee hearing, ranking member Jeff Sessions (R-Alabama), said the report showed the ACA will increase the deficit by $6.2 trillion over the next 75 years.
ACA cost curbing provisions include reduced payments from Medicare and Medicaid, the creation of a 15-member Independent Payment Advisory Board to make recommendations to reduce Medicare costs, and new taxes to pay for the health care expansion.
GAO releases report on high risk government programs
Posted by Michal McDowell on February 15, 2013
The Government Accountability Office (GAO) yesterday released an update regarding high risk government programs. In the report, GAO detailed 30 high risk areas, including Medicare and Medicaid.
GAO assigned Medicare as a high risk area because while the program covered beneficiaries at an estimated cost of $555 billion, the program reported improper payments estimated to be more than $44 billion. GAO identified several opportunities to modify Medicare to streamline program operations. Such opportunities include…
CMS issues proposed rule on regulatory burdens
Posted by Michal McDowell on February 5, 2013
Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule, which would reform Medicare regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on health care providers and suppliers, as well as certain regulations under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The rule would enable health care professionals to devote resources to improving patient care through the elimination or improvement of requirements that currently impede quality or divert resources.
KFF publishes report on sustaining Medicare
Posted by Michal McDowell on January 31, 2013
A report recently released by the Kaiser Family Foundation (KFF) serves as a review of Medicare policy options that may be discussed in upcoming budget debates. The report presents a wide array of options in several areas and lays out the possible implications of these options for Medicare beneficiaries, health care providers, and others, as well as estimates of potential savings, when available.
The report includes options in the following areas:
- Medicare eligibility, beneficiary costs, and program financing;
- Medicare payments to providers and plans;
- Delivery system reform and care for high-need beneficiaries;
- Medicare program structure; and
- Medicare program administration, including program integrity.
Transforming Health Care Delivery
Posted by Mark Dorley on January 16, 2013
Experts and stakeholders agree the current health care system is unsustainable. By 2020, health care spending will comprise almost 20% of the gross domestic product. Furthermore, an ever growing body of evidence clearly indicates that the system is not experiencing improvements in quality that are reflective of the cost growth.
The Patient Protection and Affordable Care Act (ACA) takes significant strides towards the transformation of the American health care delivery system from a system that rewards volume to a system that rewards quality and value. The programs and initiatives…
Health Affairs article reports health care spending growth remains low
Posted by Michal McDowell on January 8, 2013
The Centers for Medicare & Medicaid Services (CMS) Office of the Actuary reported in a recently published Health Affairs article that national health care spending growth remained at 3.9 percent in 2011 for the third year in a row. Although the national level of health care spending growth remained relatively stable, personal health care spending accelerated from 3.7 percent to 4.1 percent. In addition, Medicaid spending growth slowed, while Medicare, private insurance, and out-of-pocket spending accelerated.