- The CMS would give inpatient psychiatric facilities a 1.6% rate increase from Medicare in fiscal 2016 under a proposed rule issued Friday. Medicare would spend $80 million more on psychiatric facilities in fiscal 2016 than in fiscal 2015, but the increase is smaller than the 2.5% boost they received for the current year. The proposal also introduces new quality metrics that will affect payments starting in fiscal 2018. They include determining whether there was an attempt to place a patient in a tobacco-cessation program after discharge, whether substance-abuse intervention was provided, if there was a screening for metabolic disorders and two other measures related to the transition of medical records.
- Inpatient rehabilitation facilities would get a 1.7% rate increase from Medicare in fiscal 2016 under a proposed rule the CMS issued last week. The policy would deliver $130 million more to rehab facilities than in fiscal 2015, even though the increase is significantly smaller than the 2.4% raise awarded last year. The rule would also make a portion of reimbursement contingent on facilities reporting on several new quality measures. The measures—which Medicare is also applying to long-term care, skilled-nursing and home health providers—would track the percentage of patients with new or worsened pressure ulcers; the percentage of patients with functional status assessments and care plans; and the percentage of patients experiencing falls causing major injuries.
- Private health insurance exchange eHealth lost $2.1 million in the first quarter this year and has lost hundreds of thousands of individual exchange members in the past year, the company reported Friday. But in typical Wall Street logic, the stock price of eHealth actually swelled more than 20% in early morning trading as revenue came in higher than expected, while losses were not as bad as expected. eHealth’s business model has suffered since the Affordable Care Act went into effect. More people are buying health plans through public insurance exchanges established under the ACA, which have become competitors to eHealth. The decline in paying members forced eHealth to lay off 15% of its workforce in March.
Inpatient psych hospitals may get 1.6% Medicare rate hike, and other news
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