Medicare Bonuses For Quality Care Going To Fewer Hospitals In 2017
More than 1,600 hospitals will earn the rewards, federal officials announce, but that is about 200 fewer than in 2016. In addition, the number of hospitals being penalized under the program is growing. Medicare officials also announce final rules for hospital off-site facilities and choose new private contractors to audit hospital billing.
Fewer Hospitals Earn Medicare Bonuses Under Value-Based Purchasing
More than 1,600 hospitals will see bonuses from Medicare in 2017 under the Hospital Value-Based Purchasing program, according to federal data released Tuesday. The number earning positive pay adjustments is about 200 fewer than last year. The program affects some 3,000 hospitals, which are penalized or rewarded based on how well they perform on certain quality measures. A hospital's performance is assessed in comparison to its peers' and to its own performance over time. The results are “somewhat concerning,” said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute. One reason was the fact that fewer hospitals are being rewarded. Another was hospitals' lack of movement in rankings. (Whitman, 11/1)
CMS Finalizes Site-Neutral Payment Rule
In a final rule that changes the way off-campus facilities are reimbursed, the CMS was flexible in grandfathering some hospitals that had to relocate their buildings because of natural disasters. The CMS on Tuesday released a final rule that stops paying hospital off-campus facilities the same as hospital-based outpatient departments if they started billing Medicare after Nov. 2, 2015. The change will make it difficult for health systems to recoup capital or operational costs for off-site facilities, even though they are responsible for continuing to equip and maintain the off-campus offices. (Dickson, 11/1)
CMS Awards New RAC Contracts; CGI Is Out
The CMS has awarded five new contracts for Medicare's controversial recovery audit contractor program. The awardees are Performant Recovery and Cotiviti, which will both operate in two regions in the U.S., and HMS Federal Solutions. Veteran contractor CGI Group will not return and it is unclear if the company re-bid. Recovery audit contractors comb through medical records at hospitals and doctors' offices and find instances of where Medicare is paying too much money. The CMS pays RACs a contingency fee every time they identify an overpayment. (Dickson, 11/1)
Also, in Medicare news --
How To Choose A Medicare Advantage Health Care Plan
Open enrollment for Medicare is underway through Dec. 7, so if you’re in the program and want to switch plans, now’s the time to shop. Each year, more and more people choose privately run Medicare Advantage plans that work like traditional health insurance, rather than original Medicare. ... If you’re happy with your Medicare, you don’t have to change anything, but knowing all your options can’t hurt. Here’s how to shop for a Medicare Advantage plan. (Glover, 10/28)
Louisville (Ky.) Courier-Journal:
U Of L Med Students Urge 'Medicare For All'
Using Halloween to underscore their message that patients deserve to be treated for illness, not tricked by high costs of health care, a group of University Louisville medical students and physicians on Monday rallied for "Medicare for all" as a solution for problems of the current health care system. (Yetter, 10/31)