WEEKLY E-BULLETIN


Sequestration In Effect; Hits Health Care

A 2% payment cut in Medicare under sequestration won’t actually take effect until April 1, according to CMS. Click here for the story. Exactly how it will be implemented won’t be known until CMS issues further written guidance, which is expected as early as today. Providers are taking sequestration in stride, many saying that it is not as bad as it could have been. Click here for that report. There are several important health care programs exempt from cuts including Medicaid, the Childrens Health Insurance Program, and VA health care programs. For a line-by-line look at what will be cut and by how much, click here for Friday’s report from OMB, which also provides an excellent overview in a cover letter to House Speaker John Boehner. The senate voted down a GOP and a Democratic plan to reduce the impact of the sequester. Click here for that story.

Nursing Home Cuts Total $782 Million: Report

Nursing homes will see a $782 million payment reduction under sequestration, according to a report released last week. The analysis lists the amount reduced in the top 10 states. Click here.

Now May Not Be The Time To Change Health Care Programs

Because the rate of growth in the government’s health care programs Medicare and Medicaid has slowed to a crawl, a growing number of experts are saying that now may not be the time to make major structural changes. There is disagreement over the cause of the slow down, which is another reason why changes now may not be wise.  Click here for the NY Times story.

Truven’s Top 100 Hospital List Released

The Truven 100 Top Hospitals list was released last week. According to Truven, the study uses objective research and independent public data to recognize the best U.S. hospitals. Hospitals do not apply and winners do not pay to market this honor. It evaluates hospitals on measures of overall organization performance, including patient care, operational efficiency, and financial stability. It compares hospitals only against similar facilities in terms of size and teaching status. Click here to see the list.

CMS Says Readmission Rates Down Because of ACA

The threat of reduced Medicare reimbursements for hospitals with high rates of readmissions has already produced results, according to the number two CMS official in testimony last week before the Senate Finance Committee. The rate of 30-day readmissions dropped to 17.8% in the fourth quarter of 2012, down from between 18.5% and 19.5% during the past five years, said CMS’ Jonathan Blum. Click here for the 16-page testimony, which is an excellent summary of CMS’ various initiatives.  Click here for the Washington Post article.

$5.1 Billion Paid to Nursing Homes Not Meeting Basic Care Requirements: OIG

Medicare paid about $5.1 billion to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators reported last week. The HHS OIG report said payments were made for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions. One out of every three times patients entered nursing homes that year landed in facilities that failed to follow basic care standards laid out by CMS, investigators estimated. Click here for the news story.  Click here for the 32-page OIG report. The OIG does not provide the names of specific facilities.

GOP Leaders Press CMS on Medicare Advantage Cuts

GOP committee leaders are pressing CMS for answers regarding the agency’s proposal to cut payments to Medicare Advantage (MA) plans by 2.3% in FY2014 and the impact previous cuts are having. In a letter to CMS, Senator Hatch (UT) and Michigan Representatives Upton and Camp said by 2017 all the cuts will result in MA enrollment being reduced by half. Click here for the letter.

HHS, CMS Issue Series of Insurance and Market Regs

HHS announced it will extend medical loss ratio deadlines in 2014 by two months so insurers can take into account the reinsurance and other premium stabilization program contributions in determining whether they are spending enough on medical care to avoid sending rebates. The rules also include guaranteed availability of coverage, guaranteed renewability, enrollment in catastrophic plans and other changes. Click here for a CMS summary. Click here for a CMS summary of benefit and payment parameters. Click here for the 483-page rule.

CMS Makes Changes in SHOP Regs

The federal government is delaying two components of the small business exchanges set to open in 2014. In a proposed rule issued Friday, HHS said SHOP exchanges don’t have to offer the employee choice model and premium aggregation until Jan. 1, 2015. State-based exchanges have the option to offer those programs in 2014, but federal-run SHOP exchanges will have a one-year delay. Click here to see the 26-page rule.

Chained CPI Plan Would Cut Health Spending: CBO

One proposal to cut health spending, now under congressional consideration, is to enact a “chained CPI.” According to a Friday report from CBO, a chained CPI would result in a $28.5 billion reduction in government health spending over 10 years. The reductions would come from changes in Medicare and Medicaid payments, health insurance subsidies in the exchanges and other health programs related to the health law, CBO said. Government-wide, chained CPI would result in a total reduction in deficits of $339.8 billion. Click here for the 1-page CBO report.

Lobbying Increases Over Future of Compounding Pharmacies

The Capitol Hill lobbying battle over the future of compounding pharmacies is growing as hospitals fear drug company’s efforts to reign in these firms will worsen the drug shortage. Drug companies say these compounding companies are draining their profits as they operate above legal limits. Click here for the report.

More Men Going Into Nursing and Earning More

More men are entering the nursing profession and are earning higher salaries than their female counterparts, concludes a new Census Bureau study. Schools are actively seeking to increase male enrollment in nursing programs, which seems to have paid off as the number of male registered nurses more than tripled to 9.6% in 2011, up from 2.7% in 1970. Click here for the report.

Physician, Clinician Shortages Not Addressed By Administration

One of the biggest threats to the success of President Obama’s health care law comes from shortages of doctors, nurses and other health care professionals. But a 15-member commission created to investigate the problem has not met in more than two years because it has not received money from Congress or the administration. Click here for the NY Times story.

New Study Details Impact of Scope-of-Practice, Supervision Laws

Scope-of-practice laws in and of themselves don’t appear to limit what primary care service patients can receive from nurse practitioners, but requirements for documented physician supervision do appear to impact where and how NPs can practice, that’s according to a researcher participating in a study released last week. Click here for the report from the Center for Studying Health System Change.

Census Bureau Says Majority of Poor Workers Not Provided Health Benefits

Just 43.3% of individuals with family incomes less than 138% of the federal poverty level — the cutoff point for Medicaid expansion — were employed by firms offering health benefits, according to a Census Bureau report out last week. That’s compared with 80.9% of workers with family incomes of at least 401% whose employer offered health coverage. The rate of individuals with employer-sponsored health coverage dropped from 64.4% in 1996 to 56.5% in 2010. Click here for the report.

1 in 5 Adult Smokers Tried Electronic Cigarettes: CDC

In 2011, about 21% of adults who smoke traditional cigarettes had used electronic cigarettes, also known as e-cigarettes, up from about 10% in 2010, according to a study released today by the CDC. Overall, about 6% of all adults have tried e-cigarettes, with estimates nearly doubling from 2010. Click here for the CDC report.

Study Says More CT Lung Screening Needed to Save More Lives

Full implementation of CT lung cancer screening in the U.S. could save more than 12,000 lives each year, even if the relatively conservative criteria of the National Lung Screening Trial are used, according to a new study in the publication Cancer.  Click here for the report.