WEEKLY E-BULLETIN


2000 Hospitals Will Lose $280 Million with Government Penalties

More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients were readmitted soon after discharge, new government records show. Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide. Penalties will increase in each of the next two years. Click here for the summary report. Click here for an excellent 4-page summary of the final CMS regulations on value base purchasing and hospital readmission programs.

Moody’s, S&P Issue Not-For-Profit Hospital Outlooks

The US not-for-profit healthcare sector continues to carry a negative outlook due to established risks as well as in response to developing trends that have become more prominent since the beginning of the year, says Moody’s Investors Service in a mid-year outlook report. Click here for details. Meantime, median ratios for U.S. not-for-profit health care systems and stand-alone hospitals were stable in fiscal 2011, Standard & Poor’s Rating Services said last week in two reports. Click here for more.

Report: CA Hospitals’ Tax Exemption Worth More Than Charity Care Provided

Private, not-for-profit hospitals in California rack up tax exemption benefits of close to $2 billion a year beyond what they return to communities in charity care, according to a new report released last week.  Click here for the 62-page report from the Institute for Health and Socio-Economic Policy. This report is instructive for every not-for-profit hospital in the U.S. Click here for a summary.

Updated State Exchange Blueprint Released

HHS last week held a Regional Implementation Forum on Affordable Insurance Exchanges, reviewing the previously released guidance and providing an opportunity for stakeholders to ask questions. The final version of the State-based and State Partnership Insurance Blueprint was released August 14, 2012 and is available here. Applications are due November 16, 2012, and HHS will make decisions either certifying or conditionally certifying Exchanges by January 1, 2013. As of August 2012, 35 states have been awarded Exchange Establishment grants, with two states (Rhode Island and Washington) receiving Level 2 grants. States can continue to apply for financial assistance through establishment grants each quarter between now and the end of 2014. To date, only 12 states have submitted letters announcing their intent to operate a state-based exchange. Click here to see those letters.

Most Hospitals Not Ready for ACOs: New Report

New survey results issued last week indicate that not all hospitals have the infrastructure in place to take on risk and manage the care and the cost of a population. Although 84.6% of respondents participating or preparing to participate in an ACO have information systems to track utilization, only 49.7% said they think they have the financial strength to accept risk. Around 70% have processes in place to continuously monitor the use and costs of services, compared with revenue received or allowed. Click here to review the 14-page report from the CommonWealth Fund.

$49 Million Awarded to States to Fight Health Care Infections

49 states will receive funding to carry out strategies to protect patients from health care-associated infections, according to an HHS announcement last week. Sixteen of those will receive funding to prevent health care-associated infections across the spectrum of health care by building multi-facility prevention initiatives (California, Colorado, Connecticut., Florida, Illinois, Iowa, Kentucky, Maryland., Massachusetts, Michigan, New Mexico, New York, Oregon, Tennessee, Vermont, and Wisconsin). The awards total about $49 million. Click here for additional information.

Cases of West Nile Virus, Influenza A and Salmonella Increasing

About 700 cases of West Nile virus have been reported to the CDC, according to the most recent CDC report. Texas, by far, has reported the largest number of cases, with Mississippi, Louisiana and Oklahoma with the next most reported cases. Click here to see the state-by-state chart of reported cases. Also, a multistate outbreak of salmonella typhimuriumi infections linked to cantaloupe has infected 141 persons in 20 states. 31 have been hospitalized and there have been two deaths in Kentucky. Click here for details. Also, 225 cases of H3N2v (Influenza A) have been reported in 11 states – most in the Great Lakes states with the highest concentration in Indiana and Ohio. Click here for more.

Court Upholds Ban on Expansion of Physician-Owned Hospitals

A federal appeals court has upheld provisions in the Affordable Care Act that limited the expansion of physician-owned hospitals. Physician Hospitals of America and Texas Spine & Joint Hospital sued the Secretary of the Department of Health and Human Services. The court concluded that Congress had a rational basis for enacting this section of the law and the law’s requirements are not unconstitutionally vague. Click here to read the court’s findings.

Pharmacies Announce Partnership with HHS

HHS last week announced partnerships with several pharmacies to help customers learn about new Medicare benefits available to them under the Affordable Care Act. These partnerships – with CVS Caremark, Walgreens, Thrifty White, Walmart, and Sam’s Club – will provide Medicare beneficiaries a range of educational materials on newly available preventive services, as well as savings on prescription drug spending in the “donut hole” coverage gap. Click here for details.

Stage 2 Meaningful Use Regs Out Soon

A final rule on Stage 2 of the Medicare and Medicaid Electronic Health Records incentive program will be released by the beginning of September, CMS said last week. Click here for more.

Number of Community Based Care Transitions Programs Increase

CMS has announced 17 new participants the Affordable Care Act’s Community Based Care Transitions Program, bringing the total to 47. The participants work with local hospitals and social service providers to support Medicare patients at increased risk of being readmitted to the hospital while transitioning from hospital stays to other care settings, such as their homes or nursing homes. The program can spend up to $500 million over 5 years under the ACA, and the agency continues to accept applications as long as funding is available. Click here for the list of all 47 participants.

CDC Says All Baby Boomers Should Get Hep C Test

CDC now recommends that all U.S. baby boomers get a one-time test for the hepatitis C virus. Data show that 1 in 30 baby boomers has been infected with hepatitis C and this population is five times more likely than other adult Americans to be infected with the virus. In addition, more than 15,000 Americans, most of them baby boomers, die of hepatitis C-related illness each year. Click here for more information.

Two Reports Identify Obesity Rates by State

A report out last week says Mississippi has the highest obesity rates in the U.S., with adult obesity rates of nearly 35%, ahead of Louisiana and West Virginia. Colorado was named the least-obese state, with about 20% of its residents qualifying as obese, followed by Hawaii and Massachusetts. Click here for the issue brief with a state-by-state report. The CDC also has a national obesity map available by clicking here.

New Study Has Recommendations on the Use of Drugs to Treat Obesity

According to a new study out last week on obesity and the use of pharmaceuticals, drugs under investigation for the clinical treatment of obesity should be reviewed as obesity treatments rather than weight loss agents. Additionally, current clinical treatment options for obesity are limited, and obesity drugs may provide an additional intervention for helping individuals who do not respond, or inadequately respond, to other treatment interventions. Click here for the 29-page study.

New Report: The Current State of Older Americans

In 2010, 40 million people age 65 and over accounted for 13% of the total population in the United States. In 2030, the number and proportion of older Americans is expected to grow significantly — to 72 million, representing nearly 20% of the population according to an interagency report released last week. Older Americans enjoy longer lives and better physical function than did previous generations, although, for some, an increased burden in housing costs and rising obesity may compromise these gains, according to a comprehensive federal report on aging. Click here.

Massachusetts Will Vote on Physician-Assisted Suicide

Massachusetts in November will vote on whether to become the third state to legalize physician-assisted suicide. Oregon and Washington voters have approved similar laws. Massachusetts’ initiative would allow a physician to prescribe life-ending drugs to a terminally ill patient. The patient has to be able to express his wishes, and take the drugs himself. The physician cannot administer the lethal dose. A poll in May by the Western New England University Polling Institute found that 60% of registered voters support “allowing people who are dying to legally obtain medication that they could use to end their lives.” Click here for the poll.

$68 Million Awarded to Support Women, Children with HIV

HHS has awarded $68 million in grants to 114 community-based organizations, hospitals and health departments nationwide to provide medical and support services for HIV-positive women and children. Click here to see the list of awardees by state and amounts.

NQF Endorses New Care Measures

The National Quality Forum has endorsed a number of new measures this month focusing on cancer care, patient safety and care coordination. Click here for the updates.

House GOP Wants Answers on “Inappropriate Lobbying Activities”

Five House Energy and Commerce Committee Republicans sent a letter last week to HHS Secretary Kathleen Sebelius calling on her to address charges of “inappropriate lobbying activities” funded through a CDC public health prevention program.  Click here to review the letter.

For a 4-page summary of CMS’ new regulations for the Inpatient Prospective Payment System, click here.
For a 4-page summary of CMS’ new regulations for the Inpatient Quality Reporting program, click here.