Medicare and Medicaid Need Innovation
Trump’s HHS seeks to encourage health care competition. (Seema Verma/Wall Street Journal)
Medicaid
Possible federal funding cuts jeopardize care
The webpage works to educate providers in these underserved areas.
—Via CMS, WASHINGTON, D.C. (July 11, 2017)—CMS launched a new Quality Payment Program (QPP) webpage dedicated to doctors and other clinicians working in small or rural practices as well as those treating patients in underserved areas. This page provides:
States Lag in Keeping Medicaid Enrollees Out of Nursing Homes
States are not doing enough to help elderly and disabled Medicaid enrollees receive services in homes and community locations instead of in nursing homes, where care is more expensive, AARP report says. (Kaiser Health News via U.S. News & World Report)
Data details health care spending for residents by service and major payer.
WASHINGTON, D.C. (June 14, 2017)—The Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary (OACT) released state-level health care spending data for the period 1991-2014.
Can Ailing Illinois Afford In-Home Care for Seniors?
Illinois’ Community Care Program is being stretched to the limit with an influx of aging baby boomers and an already deep budget crisis. (Alejandra Cancino/Crain’s Chicago Business)
AAHomecare and NEMEP partnered to study the effects on suppliers in the state.
WASHINGTON, D.C. (February 22, 2017)—Last June, The New York State Department of Health (NYS DOH) announced an “Incontinence Supply Management Program” for all Medicaid beneficiaries that would implement minimum quality standards for incontinence products to take effect on September 1, 2016. In addition to the quality standards, NY DOH also awarded a preferred vendor contract to TwinMed, LLC for incontinence products to be purchased by Medicaid providers.
The group works to keep low-income seniors at home.
CAMBRIDGE, Mass. (February 14, 2017)—Senior Whole Health (SWH), which helps keep low-income seniors living independently at home by providing comprehensive health care and support services, enrolled its 20,000th member in February.
The paper will help frame discussions with state Medicaid directors around CURES Act regulations.
WASHINGTON, D.C. (February 9, 2017)—The American Association for Homecare (AAHomecare) today released a briefing paper designed to assist home medical equipment leaders nationwide in their efforts to engage state Medicaid directors on future Medicaid rate-setting deliberations involving home medical equipment.
WASHINGTON, D.C. (January 18, 2017)—CMS published guidance to the states on Friday, January 13, in an effort to give strategies to the state to ensure access to DMEPOS is available. This was issued due to comments from 2016 on CMS 1651-P and 2011 comments submitted in response to Federal Register Request for Comment on alignment under Medicaid and Medicare. While CMS cannot enforce these suggestions, we believe that they would benefit both states and providers.
WASHINGTON, D.C. (January 17, 2017)—Data is the lifeblood of the value-based payment environment. Every time a doctor takes care of a patient, we have an opportunity to use information in ways that help patients get better care. The goal is to use the information from each patient encounter to make the next encounter better—across the entire health care system. But it is easier said than done.
WASHINGTON, D.C. (January 11, 2017)—AAHomecare’s State Leaders Council, comprised of state association leadership from across the country, formed a Work Group to collaboratively develop strategies and coordinate resources for tackling the provision in recent CURES legislation that limits the federal portion of Medicaid spending to competitive bidding prices for DMEPOS starting in 2018.
WASHINGTON, D.C. (January 9, 2017)—The Centers for Medicare & Medicaid Services (CMS) today finalized rules governing home health agencies that will improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights. These Medicare and Medicaid Conditions of Participation are the minimum health and safety standards a home health agency must meet in order to participate in the Medicare and Medicaid programs.
LOUISVILLE, Ky. (October 17, 2016)—Almost Family, Inc.—a leading provider of home health nursing services—today announced that it has signed a definitive agreement to acquire a controlling interest in the entity holding the home health and hospice assets of Community Health Systems, Inc. (referred to herein as CHS Home Health, pertaining solely to the home health and hospice business of CHS).
WASHINGTON, D.C. (October 12, 2016)—David J. Totaro, chairman of the Partnership for Medicaid Home-Based Care (PMHC), issued the following statement today in response to a recent call by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) concerning improved program integrity in personal care services:
WASHINGTON, D.C. (September 28, 2016)—The Centers for Medicare & Medicaid Services (CMS) announced that 2017 Medicare Advantage premiums will remain stable and more enrollees will have access to higher quality plans while, for the seventh straight year, enrollment is projected to increase to a new all-time high.
PHILADELPHIA (September 22, 2016)—Sellers Dorsey announced that Darin Gordon has partnered with the firm as a senior strategic advisor. Gordon is the immediate past Medicaid director in Tennessee, where he earned recognition for both his success and longevity in the role, having served for 10 years under governors from both political parties.