The Centers for Disease Control and Prevention (CDC) reports that Arizona has administered 5,408,077 doses of vaccine and 3,076,913 people have received at least one dose of vaccine. This means that 42.8% of the state has now been vaccinated. Nationally, 46.4% of people have been vaccinated and 35.4% of people are fully...
The Centers for Medicare and Medicaid Services (CMS) is deep into Medicare alternative payment model (APM) revision and adjustment. One such program undergoing review is the Medicare Shared Savings Program (MSSP) and the revisions include major changes to quality reporting methodologies, the crux of the program.
CMS posted its final...Arizona News
The theory was that recovery in SNFs would occur with COVID-19 vaccination uptake among staff and residents, visitation policies of nursing homes, the willingness of family members to place their loved ones in the SNF setting, and acute care’s return to normal.
Now, the question is whether or not hospitals will continue to discharge...National News
The U.S. Food and Drug Administration approved Farxiga (dapagliflozin) oral tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease (CKD) who are at risk of disease progression.
The efficacy of Farxiga to improve kidney...
There were 742 new cases of COVID-19 reported in Arizona on May 5, bringing the state total to 866,022 since testing began. There were 5 new deaths and the total is now 17,360. Intensive care unit beds are 11% occupied by COVID-19 patients and 15% of beds remain available.
This information comes from the Arizona Department of Health...
The Centers for Medicare and Medicaid Services (CMS) issued a final rule making changes to the Comprehensive Care for Joint Replacement (CJR) payment model last week. The final rule extends the payment model for three performance years for participating hospitals and allows for CMS to test modifications to the model.
The final rule...News
In a retrospective analysis of post-acute claims by The American Journal of Managed Care, patients enrolled in Medicare Advantage have better outcomes and lower cost following skilled nursing facility discharge than patients enrolled in traditional fee-for-service Medicare.
Medicare Advantage v.s. traditional Medicare
Established...Arizona News
There were 649 new cases of COVID-19 reported in Arizona Wednesday, bringing the state total to 855,804. Six new deaths were reported, and will be retroactively reassigned to the dates on which the deaths took place. COVID-19 patients occupy 10% of intensive care unit beds and 14% of available hospital beds.
This information comes...CMS Rules
After a 1.7 billion in nursing home payment increase, the federal government is mulling several options to recalibrate the Medicare payment structure for skilled nursing facilities as it seeks to achieve its intended goal of budget neutrality, with the aim of shutting off excess payments as soon as possible.
SNF News
According to the...Arizona News
AHCCCS seeks waiver and expenditure authority from CMS on two waiver demonstration projects.
The AHCCCS Housing and Health Opportunities (H2O) demonstration wants to improve and expand housing services and interventions for AHCCCS members who are homeless or at risk of becoming homeless.
With this waiver approval, AHCCCS will work...CMS Rules
The Medicare Payment Advisory Commission (MedPAC) agreed that the Department of Health and Human Services (HHS) must put together a consolidated group of alternative payment models in order to improve demonstrations.
From the commission's recommendation:
The Secretary should implement a more harmonized portfolio of fewer spending...CMS Rules
This week, the Supreme Court suspended hearings on Medicaid work requirements as other Trump era Medicaid policies come under fire. Plus, states aren't quite meeting reporting requirements and more reporting adjustments could be on the way.
The U.S. Supreme Court suspended its review of the Medicaid work requirements and removed the...National Reports & Surveys
This week The Centers for Medicare & Medicaid Services announced that it is lifting a suspension on hospital survey activities that was implemented during this winter's surge in COVID-19 cases and hospitalizations. An immediate resumption of survey activities for all complaints is allowed once more.
Background:
On Jan. 20 of...National News
Despite impassioned criticism from the hospital industry and a lawsuit from the American Hospital Association, CMS finally implemented its long-delayed hospital transparency rule on January 1, 2021. Multiple reports suggest that now, hospitals' are resisting complying with it.
The CMS Rule requires hospitals to “establish,...Arizona News
The Centers for Medicare & Medicaid Services have announced the final list of participants approved to take part in CMS’ Emergency Triage, Treat, and Transport (ET3) Model - a payment model that aims to provide greater flexibility to ambulance care teams to address emergency health care needs of Medicare Fee-for-Service...Government
The American Rescue Plan is set to reduce health care costs, expand access to insurance coverage and address health care disparities. The Biden-Harris Administration is working to ensure that nearly everyone who buys their own individual or family health insurance through a Marketplace can receive a tax credit to reduce their premiums....National Reports & Surveys
The payment gap between independent and hospital-employed doctors is significant. The average gaps were $63,000 for primary care doctors, $178,000 for medical specialists and $150,000 for surgeons.
Based on Medicare claims data from 2010-2016, research found that the program's payments for doctors' work were $114,000 higher per...CMS Rules
On January 14, the Centers for Medicare and Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters for 2022. This included a finalized user fee of 2.25% of premiums for insurers on the federally facilitated exchange. The rule also allows states to enroll eligible patients in the individual marketplace.
Insurers...National News
In the midst of a catastrophic pandemic and the start of a new presidential administration, there is both urgency and optimism in those looking to the future of healthcare in America. This week, two major reports were published highlighting how the country can and should improve American's health in the coming months and...National News
According to data from the Centers for Medicare and Medicaid Services (CMS), participation in the Medicare Shared Savings Program (MSSP) is down nearly 8%. In 2020, 517 accountable care organizations (ACOs) participated, but in 2021 only 477 will participate.
A CMS fact sheet on shared savings programs demonstrates that earned shared...