An influential advisory panel plans to ask Congress to cut payments to some stand-alone emergency departments. The proposal could save Medicare up to $250 million annually if enacted into law.
Hospitals' Medicare margins are expected to continue falling in 2018, according to MedPAC. The aggregate margin hit a negative 9.6% across hospitals in 2016 and could sink to a negative 11% this year.
The lower reimbursements are a challenge in rural communities with high Medicare Advantage penetration.
An influential policy organization that advises Congress on Medicare issues has finalized a proposal to replace MIPS under MACRA. However, some commission members still question whether MIPS should be junked.
The influential congressional advisory committee wants to eliminate two quality programs and merge two others in order to reduce hospitals' reporting and compliance burden.
House lawmakers pushed back against the Medicare Payment Advisory Commission's calls to cut Medicare reimbursements to some types of providers.
House lawmakers pushed back Thursday on the Medicare Payment Advisory Commission's calls to cut Medicare reimbursements to some kinds of providers, saying organizations in their districts tell them they could not survive with the proposed cuts.
Drugmakers and providers say the newest proposal to change the way drugs are paid for under Medicare Part B is likely dead in the water.
The Medicare Payment Advisory Commission has suggested hospitals and doctors get payment bumps in 2018. Other sectors, including ambulatory surgery centers, skilled-nursing facilities and inpatient rehabilitation facilities, should get no increases, the group says.
While the change will save the federal government $9.3 billion over 10 years, healthcare lawyers say the new payment environment sets hospitals up for a tough battle with commercial payers as they try to cover their costs and bring care closer to patients.
Modern Healthcare Midwest Bureau Chief Bob Herman recently interviewed Mark Merritt, CEO of the Pharmaceutical Care Management Association, the PBM trade group, to get his take on the issues facing the industry.
The CMS continues to adjust its formula for distributing disproportionate-share payments for safety net hospitals based on initial assumptions about insurance coverage under the ACA that have not panned out.