Medicare/Medicaid

Study: Readmissions Rates Tied More to Hospital’s Socioeconomics, not Performance

May 11, 2012    
news
According to a new study presented at the American Heart Association's (AHA) Quality of Care & Outcomes Research Scientific Sessions 2012, differences in regional hospital readmission rates for heart failure have more to do with the availability of care and socioeconomics than to hospital performance or patients' degree of illness.

Premier: CMS Needs to Act Quick on Stage 2 Final Rule

May 2, 2012    
news
The Premier healthcare alliance has submitted its comments in response to the Stage 2 Electronic Health Record (EHR) Incentive Program proposed rule, announced in February by the Centers for Medicare & Medicaid Services (CMS). While the for-profit stakeholder collaborative organization supported CMS’ decision to extend Stage 1 through 2013, it encouraged CMS to publish a final rule specifying Stage 2 requirements no later than August 2012.

D.C. Report: Congress Focused on CMS Innovation Center, EHR Incentives at $4.5 Billion

May 1, 2012     Jeff Smith, Assistant Director of Advocacy at CHIME
article
Three Senators sent a letter to HHS Secretary Sebelius, reminding her office of a November request for information on the CMS Innovation Center. “[W]e remain concerned that at a time of significant uncertainty for the fiscal health of the U.S. government, funds are being expended by the Innovation Center with little to no actual value provided,” Sens Enzi (R-WY) Coburn (R-OK) and Hatch (R-UT) say in their letter.

OmniCare to Distribute Free Wireless for Medcaid Member Communication

April 24, 2012    
news
OmniCare Health Plan Inc., a Medicaid health plan serving people throughout the state of Michigan, has partnered with Assurance Wireless to help spread usage of the latter’s federal Lifeline Assistance program to OmniCare’s 47,000 enrollees. Assurance Wireless will provide cell phone service, a wireless phone and 250 free minutes of wireless voice service monthly to eligible low-income customers, which will aims to allow OmniCare to strengthen channels of communication with its members to promote preventive health care and regular check-ups with their doctors.

CMS Announces Fraud Protection Rule

April 24, 2012    
news
The Centers for Medicare & Medicaid Services (CMS) has announced final rule aimed at preventing fraud in Medicare and is reportedly estimated to save taxpayers nearly $1.6 billion over 10 years. The rule aims to ensure only qualified, identifiable providers and suppliers can order or certify certain medical services, equipment and supplies for people with Medicare. It also aims to help beneficiaries receive quality care with CMS verifying the credentials of a provider who is ordering or certifying equipment and supplies.

Report: Readmission Rates are Misleading

April 23, 2012    
news
A study from doctors in the departments of neurological surgery and orthopedic surgery at the University of California at San Francisco (UCSF) has concluded there may be problems with how readmissions rates are reported. According to the study, comparing publicly available overall readmission rates can lead to misinformation

Specialized EDs

April 11, 2012     John DeGaspari
blog
An interesting article in yesterday’s New York Times described what it says is part of a growing trend in healthcare: trying to cater to the medical needs of elderly patients. A few months ago Mount Sinai Medical Center opened its first geriatric ED, which was modeled on one at St. Joseph’s regional Medical Center in Paterson, N.J., according to the Times. Mount Sinai maintains that its geriatric ED is the first one of its kind in New York City.

CMS Extends HIPAA 5010 Deadline

March 15, 2012    
news
The Centers for Medicare & Medicaid Services' (CMS) Office of E-Health Standards and Services (OESS) has announced it not initiate enforcement action for those who are forced to comply with Health Insurance Portability and Accountability Act of 1996 (HIPAA) 5010 regulations for an additional three months, through June 30, 2012.

CMS Accepts 23 New Care Transition Participants

March 14, 2012    
news
The Centers for Medicare & Medicaid Services (CMS) have announced 23 additional participants in the Community-based Care Transitions Program (CCTP) program. They will join seven other community-based organizations, who are participating in the program that partners hospitals and other health care and social service providers to support high-risk Medicare patients who may be readmitted while transitioning from hospital stays to their homes, a nursing home, or other care setting.

CMS Partners With Text4Baby

February 28, 2012    
news
The Centers for Medicaid & Medicaid Services (CMS) will partner with Text4Baby, a free national health texting service to promote enrollment in both Medicaid and the Children’s Health Insurance Program (CHIP), to provide pregnant women and new mothers free text messages on healthcare issues. The announcement is part of activities marking the anniversaries of both the signing of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and the launch of Text4Baby.

This Time, It’s Really Real

February 14, 2012     Mark Hagland
blog
Just recently, I’ve been looking back at some statistics of particular interest, as many of us head off to HIMSS12 in Las Vegas next week. One data-driven report that came out in late September 2011 strikes me now as especially worthy of comment. On Sep. 28, the folks at the Lebanon, N.H.-based Dartmouth Atlas Project released a report showing that little progress was made during the five-year period from 2004 through 2009 in the area of working to reduce hospital readmissions.

Study: Automation for Medicare Reimbursement Needs Work

February 7, 2012    
news
IVANS, Inc. a national health information exchange based out of Stamford, Conn., announced results from a study that showed automating claims processes play a critical role in making the Medicare reimbursement process faster. According to the study, 39 percent of providers still use paper to submit claims to commercial payers, but less than one percent use paper for Medicare claims and only 11 percent still use paper for Medicaid claims.
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