WEEKLY E-BULLETIN


 

Health Exchange Insurance Application Down to Three Pages: CMS

CMS has announced that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from 21 to three pages, and the application for families has been reduced by two-thirds. The consumer friendly forms are much shorter than industry standards for health insurance applications today. In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children’s Health Insurance Program (CHIP) and tax credits that will help pay for premiums. Click here for the USA Today story. Click here for the CMS announcement.

 

Federal Exchanges Will Have Less Money to Recruit 

States relying on the federal government to run their health exchange marketplaces are getting far less money than states setting them up themselves as a result of how the health law was written, according to an analysis by Kaiser Health News. In addition, some states that are running their own operations are supplementing the federal dollars with their own funds. Click here for the story.

 

Concern Grows About Lack of Insurers on Exchanges

Only six insurance carriers have told the state of Illinois they want to sell a combined 165 health policies on the state’s online insurance marketplace under the nation’s new health care law, numbers far lower than expected, raising concerns the trend will hold true across the country, according to a report out last week. Click here.

 

CMS Proposes Numerous Changes Impacting Hospitals; New Summary Available

CMS estimates that 434 hospitals will receive a Medicare wage index increase because of the proposed changes made in the FY Inpatient Prospective Payment System regulations released a week ago. Other changes include: Medicare Dependent Hospitals have until August 31 to apply for Sole Community Hospital status, if they qualify; changes to the hospital readmission reduction program and the Value Based Purchasing program. Here is a summary of the 1,400 page document into seven pages.  Click here.

 

Less Than Half of States Will Likely Expand Medicaid 

As of last week, 16 states plus the District of Columbia have approved the expansion of Medicaid under the Affordable Care Act or are headed in that direction, according to an update from the Pew Foundation. 27 have rejected it or about to and seven states could still go either way. Click here to see a state-by-state report.

 

Study: Medicaid Doesn’t Improve Physical Health Quickly

A new study released last week indicates that the Medicaid program is unlikely to quickly improve enrollees’ physical health. The research, published in the New England Journal of Medicine, did find that low income people who recently gained Medicaid coverage in Oregon used more healthcare services. Click here for the report from the NEJM. Click here for the Washington Post story.

 

Intensity of Emergency Department Care Increasing: AHA Study 

Sicker, more complex Medicare patients are driving up the intensity of emergency department care, a new report released last week by the American Hospital Association found. Recent data indicate that the number of ED services provided to Medicare beneficiaries is growing and that patients’ needs are shifting toward services that demand the use of more resources. Click here to review the six page report.

 

Rehab Rule Will Increase Payments 2%

CMS last week released a proposed rule that would increase the total payments to inpatient rehabilitation facilities next year by 2%, or about $150 million. The rule also outlines a requirement that IRFs demonstrate that 60% of their patients meet certain standards, including the need for intensive rehabilitation services, in order to be paid on the IRF schedule, which is higher than the standard hospital inpatient prospective payment system. Click here for the 186 page rule. Click here for a summary from CMS.

 

SNF Rules Increases Payments 1.4%

CMS also issued a proposed rule outlining proposed FY14 Medicare payment rates for skilled nursing facilities. Based on proposed changes contained within this rule, CMS estimates that aggregate payments to SNFs will increase by $500 million, or 1.4%, from payments in FY13. Click here for the CMS summary.

 

Aetna Increasing Number of ACO Deals

Health insurance giant Aetna said last week it has signed 20 Accountable Care collaboration agreements with health systems, with an additional 36 letters of intent in place and a pipeline of over 200 opportunities. Aetna’s CEO Mark Bertolini said he remains confident in the company’s ability to grow to 30 ACO partnerships in 2013, encompassing approximately 375,000 members and $1.5 billion in revenues. Click here to read the transcript from Aetna’s quarterly investor update.

 

Med School Enrollment Up Substantially

First year medical school enrollment in 2017-2018 is projected to reach 21,434—a 30% increase from 2002–2003, according to a report released last week by the Association of American Medical Colleges. Of the projected growth from 2002–2017, 62% will be at the 125 medical schools that were accredited as of 2002. New schools since 2002 will provide 31% of the growth. Click here to read the 16 page report.

 

Progressives Not Pleased with Obama’s Medicare Proposals

The Obama Administration’s budget proposal calling for some significant Medicare reform, especially combining Part A and Part B, has got left leaning groups concerned saying they believe beneficiaries will end up shouldering more of the cost. Click here for the story.

 

House GOP Leader Calls For Vote to Repeal Obamacare

The number two House Republican told his caucus last week through a memo that leadership will be scheduling another vote to repeal Obamacare in the near future. Rep. Eric Cantor (R-VA) outlined the House’s priorities when Congress returns to session this week, click here to read his memo.

 

CMS to Remove Certain HACs from Public List for Now

CMS said last week it is planning to strip the site of the eight hospital-acquired conditions, which include infections and mismatched blood transfusions, while it comes up with a different set. This is according to report from Bloomberg News  The agency said it’s taking the step because some of the eight are redundant and because an advisory panel created by the 2010 Affordable Care Act recommended regulators use other gauges. Click here for the story.

 

DOJ Suing Nation’s Largest For-Profit Hospice Company

The U.S. Justice Department is suing Chemed Corp and its hospice subsidiaries, including the biggest U.S. for-profit hospice chain, Vitas Hospice Services, alleging false billings for Medicare hospice services. Click here for the report from DOJ.

 

Hospice Payments to Increase 1.1 Percent

CMS issued a proposed rule that would update FY14 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. As proposed, hospices would see an estimated 1.1% ($180 million) increase in their payments. Click here for the CMS summary.

 

Coalition To Tackle Patient Medication Adherence

Getting patients to take their medications as prescribed is an intractable problem costing the U.S. $290 billion a year according to a 2009 report by the New England Healthcare Institute. Chronic disease patients, who account for the majority of health care costs, risk complications and hospitalization, one out of three, when they skip their drugs or fail to take them properly. A national coalition of pharma interests have come together to develop initiatives to tackle the problem. Click here for details.

 

Middle-Aged Suicide Rises

The suicide rate among middle-aged Americans climbed a startling 28% in a decade, a period that included the recession and the mortgage crisis, the Centers for Disease Control reported last week. Click here for the CDC report.