CMS Releases Proposed 2009 Outpatient/ASC Rule - July 2008

The Centers for Medicare & Medicaid Services today released a proposed rule updating Medicare payment rates for hospital outpatient and ambulatory surgery center services for calendar year 2009. According to the rule, CMS would continue to transition to the new ASC payment rates, with ASC services paid at a 50/50 blend of the 2007 ASC payment and the 2009 ASC payment, which are 65% of the hospital outpatient rate. Hospitals reporting seven outpatient quality measures in 2009 would receive a 3.0% inflation update, while eligible hospitals not submitting data would receive a 1.0% update. The proposed rule outlines the process for validating hospitals’ quality data; proposes adding four new imaging efficiency quality measures for public reporting in order to receive a full update in CY 2010; and seeks comment on 18 other quality measures for potential inclusion at a future date. It also would alter how CMS pays for imaging services when multiple services are provided in one session, by creating a single payment for certain multiple imaging services such as ultrasound, computed tomography and magnetic resonance imaging. The rule also changes the way partial hospitalization services are paid, reduces payments for separately payable drugs, and proposes changes to the hospital Medicare cost report for drugs and biologicals. The rule will appear in the July 18 Federal Register, with comments accepted until Sept. 2. AHA staff is analyzing the rule, and a Special Bulletin with further details will be sent to AHA members on Monday.

Study Examines Parity in State Health Coverage Initiatives - July 2008

While more than one in four uninsured U.S. adults has a mental illness or substance-use disorder, many state initiatives to cover the uninsured neglect those conditions, according to a new study by the National Alliance on Mental Illness and National Council for Community Behavioral Healthcare. Eleven of the 18 states examined included parity in mental health coverage in at least one program or proposal for the uninsured, while only five included parity for substance-use disorders, the study found. Among other concerns, few states included mental illness and substance-use disorders in their wellness and chronic disease management programs, the groups said.

Joint Commission Reorganizes Hospital Standards for 2009 - June 2008

The Joint Commission has reorganized its hospital standards and elements of performance for 2009, and for the first time has made them available online. The reorganization added no new requirements, but clarified the language of existing requirements, some of which were deleted, consolidated or separated. The Joint Commission also renumbered and reordered the standards to allow electronic sorting and the addition of new requirements in the future. The Joint Commission plans an extensive outreach effort to help organizations understand the changes before the standards take effect on Jan. 1.

HRSA Issues Health Center Report, Locator Tool - July 2008

Federally funded health centers provided a medical home to more than 16 million patients in 2007 at an average cost per patient of $559, according to a new report from the Health Resources and Services Administration. About 6.2 million of those patients lacked health insurance, up from 4 million in 2001. More than 1,000 federally funded health centers deliver services at 6,000 sites in U.S. states and territories, about half in rural and half in urban areas. These health centers employ 8,000 physicians and more than 4,700 nurse practitioners, physician assistants and certified nurse mid-wives. Annual funding for federal health center programs nearly doubled from 2000 to 2007 to more than $2 billion. Consumers can locate the nearest federally funded health center using a new online tool.

Survey: Large Employers Offering Wellness Programs, Incentives - July 2008

Seventy-seven percent of large employers offer health and wellness programs, and 48% offer disease management programs, according to a new survey by the ERISA Industry Council and National Association of Manufacturers. Seven in 10 respondents with health and wellness programs offer incentives for employees to participate, with the average incentive valued at just under $200. Gift cards were the most popular incentive, followed by premium reductions, cash, merchandise and health account contributions. Many large employers without health and wellness programs planned to add them in the next year.

Archives