How do value-based purchasing programs affect hospitals’ bottom lines? This is a particularly important question as the Affordable Care Act (ACA) mandates that CMS reward high-quality, low-cost hospitals with bonuses and give financial penalties to low-quality, high-cost hospitals. In 2003, CMS began a pay-for-performance (P4P) demonstration. Using this demonstration as a natural experiment, Kruse et [...]
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Benefits are taking up a continually greater share of employee compensation. This trend is as true for hospitals as any other industry. Keenan Health Care summarizes some recent trends for California hospitals. According to a survey of 83 California health care organizations (representing 219 hospitals): Benefits represent 28% of the employee compensation for the average [...]
Read the rest of this entry »P4P for Maryland Hospitals
Maryland is a unique state for Hospitals. Since 1977, Maryland’s Health Services Cost Review Commission sets payment rates for all hospitals regardless of the payer. This approach is only feasible because Maryland receives a federal waiver that exempts its hospitals from national Medicare and state Medicaid fee schedules. Just as Medicare has begun implementing its [...]
Read the rest of this entry »Can closing a hospital improve the quality of care?
The closing of St. Vincent’s Hospital in the Village in New York City at first glance would reduce access to care for New York residents living in the area. To fill the void, however, a number of non-traditional providers have entered to fill the space. For instance, the number of stand-alone urgent care centers are [...]
Read the rest of this entry »For-profits dominate the Hospital landscape in France?
“European healthcare systems…are always presented [in the media] as public sector nirvanas. The Guardian in the UK, for instance, can write po-faced articles praising the French system without acknowledging, for a single moment, that private-for-profit hospitals make up a larger percentage of sales in France than they do in the USA. Or that home care [...]
Read the rest of this entry »Medicare Payments to Hospitals to Rise 2.8 Percent in 2013
Medicare will increase payments to hospitals by 2.8 percent in 2013. This net change is due to five major adjustments. Hospital market basket Adjustment: 2.6 percentage points Multi-factor productivity adjustment: 0.7 percentage points Affordable Care Act Provisions: -0.1 percentage points Remaining FY 2008 and FY 2009 Prospective Documentation and Coding Adjustment: -1.9 percentage points Restoration [...]
Read the rest of this entry »Financial Outlook for Non-Profit Healthcare Firms…
…is poor according to Moody’s. “By limiting the expansion of insurance coverage, the ruling blunts the impact of one of the law’s few credit positive features. Uncertainty regarding which states will and will not participate in the Medicaid expansion adds to the political gridlock regarding healthcare reform, making it increasingly difficult for hospitals to perform [...]
Read the rest of this entry »How Massachusetts hospitals increased Medicare reimbursement rates by 20 percent
The answer is by using exceptions/loopholes to payment rules. The Medicare Wage Index adjusts payments to hospitals based on hospital worker wages wages in the hospital’s labor market. Payment exceptions, in this case the rural floor, causes payments to hospitals in Massachusetts to increase by 16.4 percent simply by having one hospital reclassify. Here is [...]
Read the rest of this entry »Why is end-of-life spending so high?
The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use [...]
Read the rest of this entry »Do safety net hospitals provide care strategically?
It is widely known that safety net hospitals provide less intensive care than hospitals whose patient base is mostly commercially-insured. One question is whether safety net hospitals discriminate the care provided based on their patients insurance status. In other words, do commerically insured individuals who visit safety net hospitals receive more care than patients treated [...]
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