Hospital readmission penalties seem to have been working as intended, by driving down 30-
day hospital readmissions and saving Medicare roughly $2.3 billion between 2010 and
2016. The unintended consequence, however, was that hospitals serving the poorest of
the poor were the most frequently penalized. Medicare has made changes to mitigate
that, but safety-net hospitals still struggle with reducing hospital readmissions largely attributable to social determinants of care, and they still risk penalties that could push them over the fiscal
edge.
No matter if you are on the facility or the partner side of Revenue Cycle Management, there is a lot of information, both legal and regulatory, to keep up with to maximize reimbursements. Here are a few things of interest that we are reading right now:
No matter if you are on the facility or the partner side of Revenue Cycle Management, there is a lot of information, both legal and regulatory, to keep up with to maximize reimbursements. Here are a few things of interest that we are reading right now:
The Trump administration couldn’t abolish the Affordable Care Act (ACA), but it did make significant changes to it and work requirements for Medicaid likely to reduce the availability of coverage or discourage enrollment. So, after years of declining uninsured rates, the U.S. saw coverage gains stall--and for some groups, even drop. That’s a key takeaway from The Uninsured and the ACA: A Primer, a 2019 report from the Kaiser Family Foundation (KFF). It provides information on how insurance has changed under the ACA, how many people remain uninsured, who they are and why they lack health coverage. We’re taking a look at what this means for our clients--and how Altruis can help.
Need another resolution for 2019? Probably not, but we have one for you anyway, and it’s important. We’re counseling our safety-net clients to pay closer attention to what’s going on with CMS.