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MedPAC discusses FY 2010 hospital payment update 12/04/2008
At its meeting today in Washington, the Medicare Payment Advisory Commission considered a draft recommendation to Congress for fiscal year 2010 inpatient and outpatient hospital payments. The draft recommendation, the same as for FY 2009, would provide hospitals with a full Medicare payment update, based on the rate of change in the market-basket index, concurrent with implementation of a quality incentive program. MedPAC staff project that overall Medicare margins will drop to -6.9% in FY 2009. A second draft recommendation would reduce the indirect medical education adjustment from 5.5% to 4.5%. Commissioners discussed options for redistributing the resulting savings from the IME adjustment. AHA Vice President for Policy Don May said, "Given the dramatic change in the economy and a significant drop in Medicare margins for hospitals, a full update is absolutely necessary for FY 2010."
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Nursing program growth slows, constrained by faculty shortage 12/04/2008
Enrollment in entry-level baccalaureate nursing programs increased just 2% in 2008 as schools turned away nearly 28,000 qualified applicants, primarily due to a faculty shortage, according to preliminary data from the American Association of Colleges of Nursing. Annual growth in the programs has slowed from 5.4% in 2007 and 16.6% five years ago. Enrollment in master's level nursing programs increased 8.7%, down from 11.7% in 2007 and 18.1% in 2006. "The nation's nursing schools are facing considerable barriers to expanding student capacity despite the calls for more nurses to replace the large segment of the workforce expected to retire within the next 10 years," said AACN President Fay Raines. "This year's enrollment increases are welcome, but largely insufficient to meet the projected demand for nursing clinicians, educators, and researchers into the foreseeable future."
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AHA to host call on Schedule H for small, rural hospitals 12/04/2008
The AHA will host a 60-minute conference call Dec. 9 for small and rural hospital members to review the Internal Revenue Service's new Form 990 and Schedule H for hospitals. The call will feature representatives from Munson Medical Center, a rural prospective payment system hospital in Traverse City, MI, and the Michigan Health & Hospital Association, which has developed "Community Benefit Tracker" software (www.cbtracker.net) to help measure an organization's influence on the community it serves. Hospitals may register for the call online. For more information, contact AHA Member Relations at (800) 424-4301.
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CMS approves IL hospital assessment program 12/04/2008
The Centers for Medicare & Medicaid Services has approved an Illinois hospital assessment program that will provide $3.2 billion in additional Medicaid funding to hospitals over five years. Hospitals will pay the state a total assessment of about $900 million per year, a portion of which will be used to attract federal Medicaid matching funds, resulting in an annual net gain in Medicaid payments of $640 million, according to the Illinois Hospital Association. Approved by the Illinois legislature this spring and supported by the state's congressional delegation, the program is retroactive to July 1. IHA President Ken Robbins and Board Chair Jim Skogsbergh said the program "will significantly improve Medicaid reimbursements for hospitals, which are far less than the costs of delivering that care, and ensures the state can play a part in helping hospitals provide essential, high quality heath care for all Illinois patients who depend on their local hospitals."
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AHRQ reports rise in hospital stays for pressure ulcers 12/04/2008
Hospital stays involving patients with pressure ulcers rose nearly 80% from 1993 to 2006, according to a new report from the Agency for Healthcare Research and Quality. In most cases, the patients were elderly and the condition was not the primary reason for the stay. More than half of the patients were discharged to long-term care.
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Study: Most Americans shop for providers by referral 12/04/2008
Most Americans still rely on word-of-mouth and physician recommendations to choose health care providers, according to a study released today by the Center for Studying Health System Change. Most consumers relied exclusively on physician referrals when choosing specialists and facilities for medical procedures. When selecting new primary care physicians, half of all consumers relied on recommendations from friends and relatives, but many also used doctor recommendations (38%) and health plan information (35%). In 2007, only 11% of American adults looked for a new primary care physician, while 28% needed a new specialist physician and 16% underwent a medical procedure at a new facility, the survey found.
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Fitch revises hospitals' credit outlook to negative 12/03/2008
Fitch Ratings yesterday revised its outlook on the U.S. not-for-profit hospital sector to negative from stable, saying investment portfolio losses, increasing uncompensated care and higher capital costs are adversely affecting many hospitals' credit profiles. "Further, state and federal budgetary pressures stemming from the economic downturn are anticipated to constrain governmental reimbursement programs, while the business sector is expected to continue to shift health care costs to its employees," the credit rating agency said. "These factors, coupled with projections for increasing unemployment over the next several months and declines in acute care utilization, are expected to depress operating profitability for the next few years." AHA President and CEO Rich Umbdenstock said the Fitch downgrade "reflects the many challenges hospitals are facing every day during this economic crisis."
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Ad urges Congress to protect jobs, secret ballot 12/03/2008
"At a time of economic uncertainty, Congress should not enact measures that threaten our economic competitiveness, including the misnamed Employee Free Choice Act," states an ad launched today by the Coalition for a Democratic Workplace, whose members include the AHA. The ad appears in Washington, D.C.-area publications. The legislation, which passed the House by a wide margin in March and is expected to be reintroduced in the new Congress, would amend the National Labor Relations Act to require employers to recognize a labor union solely through the "card-check" process, ending employees' long-standing right to a secret ballot election. According to a CDW survey, support for maintaining private ballots in union organizing cuts across party lines, even among union households.
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Medicare proposes non-payment policy for surgical errors 12/03/2008
The Centers for Medicare & Medicaid Services yesterday proposed national Medicare coverage policies preventing the program from paying for certain serious surgical errors. The proposed policies would prohibit payment for performing the wrong surgical or invasive procedure, as well as procedures on the wrong body part or patient, errors which the National Quality Forum identifies as Serious Reportable Events. CMS will accept comments on the proposed coverage policies through Jan. 1.
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CMS issues final rule on state Medicaid benefit alternatives 12/03/2008
The Centers for Medicare & Medicaid Services today published a final rule giving states more flexibility in defining the benefits covered by their Medicaid programs, as provided under the Deficit Reduction Act of 2005. The rule allows states to amend their Medicaid plans to offer alternative benefit packages called "benchmark plans," which are either approved by the Health and Human Services secretary or equivalent to state or certain federal employee coverage.
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