Posts Tagged ‘CMS’

Medicare, Medicaid Head Rallies Insurance Companies

Thursday, September 30th, 2010

Controversial CMS chief wants insurers to work with healthcare providers to make reform work.CMS administrator Donald Berwick has asked the insurance industry to work in good faith to implement healthcare reform in a timely manner. Dr. Berwick made his plea at a Medicare conference sponsored by America’s Health Insurance Plans, the health insurance industry’s trade group.

“We need your help, our nation needs your help,” Dr. Berwick said, noting that companies, CEOs, healthcare professionals and managers all play a role in achieving the objective, yet the insurance industry “can be among the keys of our success, the central part in navigating the success of healthcare reform.  We have a job to do, we need to make care better for America.”  Berwick told the audience that he plans to work with others at CMS to build relationships and partnerships to assure that the Patient Protection and Affordable Care Act works as intended.  “If we steadily work together to make care what it can become, trust will resurface and the rest will follow,’ he said.

Dr. Berwick, who President Barack Obama named to his post in a recess appointment that bypassed the Senate confirmation process, is not well liked by Republicans because he once wrote an article that praised Britain’s National Health Service, raising concern that he will introduce healthcare rationing.  He tried to allay those fears by saying “I urge lower costs without harming a hair on any patient’s head.  It’s a clear, stark reality.  Our healthcare system, in its current form, is not up to that job.  We cannot, with our current system of care, give Americans the care that they need and want and deserve.”

The most pressing issue is improving patient safety and cutting deaths that result from unnecessary medical errors, a specialty that Dr. Berwick developed when he headed the Institute for Healthcare Improvement.  He also called for improved prevention and treatment of diseases like obesity and depression.

HHS Focusing on Expanding Rural Hospitals’ Reach

Thursday, September 9th, 2010

HHS is working to enhance healthcare offered at rural hospitals.  The Department of Health and Human Services (HHS) is expanding CMS’ Rural Community Hospital Demonstration. The action is being taken as part of the Affordable Care Act and will set up 20 additional hospitals in states eligible for improved reimbursement for patient services.  To participate, these small community hospitals serving rural areas must be located in states with low population density, including Alaska, Arizona, Arkansas, Colorado, Idaho, Iowa, Kansas, Maine, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah or Wyoming.

The hospitals – which must be located in a rural area – can have no more than 51 beds, provide emergency-care services and must not be a designated critical-access facility.  According to HHS, the goal is to test “the feasibility and advisability of cost-based reimbursement for small rural hospitals that are too large to be critical access hospitals.  In recent years, hospitals in this category have experienced negative Medicare margins on inpatient services.  CMS is conducting an extensive evaluation of the demonstration, testing the benefits to the community and financial impact on participating hospitals.”

New York Public Hospital Facing a $1 Billion Loss

Tuesday, March 23rd, 2010

New York City public hospitals demonstrate difficulties of staying afloat.  That fact that New York City’s public hospitals could lose $1 billion illustrates the difficulty that healthcare systems face in their efforts to stay afloat.  New York City Health and Hospitals Corporation has projected a billion dollar loss through June 30, 2011, despite an expected infusion of “hundreds of millions of dollars” in retroactive Medicaid payments.

The Medicaid payout, as well as cost-cutting efforts and improvements to efficiency will help the 12-hospital system achieve an operating gain as of June 30.  Operations, however, will “burn through that at a pretty torrid rate,” notes system president Alan Aviles.  The growing demand for subsidized and free care during the recession, as well as cuts to Medicaid – which covers approximately two-thirds of the system’s patients – makes balancing the budget problematical.

New York’s public hospitals saw the number of uninsured patients grow by 4,000 in 2009, 36,000 in 2008 and 17,000 in 2007.  According to Aviles, the growth among the uninsured is leveling, but his system has limited capacity to accept new patients.  The $1 billion doesn’t include approximately $70 million in payment cuts and tax increases contained in the New York state budget for the fiscal year that begins in April.  The gloomy forecast assumes a $300 million cut to the system’s disproportionate-share payments, which are financial assistance given to hospitals that serve low-income patients.  Aviles is lobbying New York legislators to reinstate these by prioritizing such spending in the public health system’s favor.

“This highlights that as this economic downturn continues, that public hospitals and other safety net systems that serve a great number of Medicaid and uninsured patients are going to be increasingly reliant on disproportionate-share payments to keep their systems afloat and solvent,” Aviles said.